Applying Method of Arch Bar in Maxillofacial Surgery without Orthodontic Treatment

교정치료 비적용 악안면수술에서 치열활봉 거치법

Temporomandibular joint(TMJ) and dental occlusion are important in functional aspect as well as in cosmetic aspect for craniofacial surgery such as orthognathic and traumatic surgery. During these operations, appropriate maxillomandibular fixation(MMF) is especially necessary to conserve or reconstruct, dynamic TMJ and functional occlusion. Arch bar is one of the most popular method to gain proper MMF. Seventeen patients including 5 patients with mandibular fracture, 12 patients with orthognathic surgery(6 patients had relatively normal occlusion, however 6 patients had facial anomalies such as hemifacial microsomia with irregular occlusal plane.) were joined in this study. Arch bar was contoured on the dental cast, which was prepared for model surgery, prior to apply it on the facial anomaly patient. On using pre-contoured arch bar, patients felt better during the procedure and surgeons saved time. Moreover, well-contoured arch bar promises precise transmission of force on the bone, which implies surgeons do not need to worry about the occlusion while fixing bony structures. Authors suggest how to apply arch bar to satisfy basic theories about dental row and occlusion based on the experience. In addition, it is proposed to contour arch bar on the dental impression prior to apply it on the patient who has irregular and complex occlusal plane.

악안면 수술에 있어서 악관절 및 교합은 미용적 측면에서 뿐만 아니라 그 기능적 측면에서 더욱 중요하다. 특히 하악이 고정된 경우뿐만 아니라 움직일 때 악관절 및 기능적 교합상태까지 보존 및 재건하고 정확한 수술을 하기 위해서 수술 전후에 적절한 MMF는 필수적이다. 이를 위해 저자들은 치열활봉에 대한 그 동안의 경험을 바탕으로 치열의 흐름에 대한 기본적 이론, 교합을 고려한 치열활봉의 거치방법 및 복잡한 교합평면을 가진 악안면 수술 환자들에 대해서 술전 인상을 이용한 치열활봉 거치법을 제안하는 바이다.