- 期刊
以暫時性錨定裝置輔助上下齒列遠心移動改善雙顎前突之病例報告
Total Arch Distalization to Reduce Bimaxillary Protrusion with Temporary Anchorage Devices
摘要
雙顎齒顎前突（bimaxillary protrusion）的矯正患者通常有上下唇突出的臉型，而矯正治療的目標需要將過於向外傾斜的上下門齒齒軸改正，並且將上下門齒往後移動，以改善齒顎的前突，故拔除上下顎小臼齒是常見的治療方式。近年來，由於暫時性錨定裝置（temporary anchorage device, TAD）的發展進步，可以作為骨性的錨定，對於輕度至中度的雙顎齒顎前突（bimaxillary protrusion）的病例，提供了非拔牙治療的可能性。本病例報告患者為28歲女性，骨性二級顎間關係，高咬合平面角，齒列是安格氏一級異常咬合，有雙顎前突（bimaxillary protrusion），笑齦（gummy smile）問題，且上顎前牙有延遲性被動萌出（altered/delayed passive eruption），牙冠長度偏短。經過兩年的矯正治療，以上顎的迷你骨板（miniplates）和下顎的迷你骨釘（miniscrews）來進行上下齒列的遠心移動（total arch distalization），並在矯正後以牙冠增長手術（crown lengthening）以改善牙冠長寬比和牙齦的美觀。其治療後的外觀和齒列前突獲得大幅改善。一年後追蹤，病人臉形外觀和牙齒咬合狀態亦維持良好，治療結果尚穩定。
並列摘要
Bimaxillary protrusion is defined as convex profile with protrusive upper and lower lips. Therefore the orthodontic treatment goal is to correct the proclination of upper and lower incisors by retracting the incisors into the space usually resulted from four bicuspid extractions. However, with extraordinary development of temporary anchorage device as skeletal anchorage, non-extraction approach could be a treatment option for patients with mild to mode rate bimaxillary protrusion.In this case report, we present the treatment of a 28-year-old female patient with skeletal Class II, high mandibular plane angle, and dental Class I bimaxillary protrusion, which combined with gummy smile and also altered/delayed passive eruption at her upper anterior teeth. After two years of orthodontic treatment, total arch distalization of upper and lower dentition was accomplished with upper bilateral miniplates and lower miniscrews. Afterwards, periodontal surgery was done to lengthen the crown for improving the ratio of crown height/width, and to improve gingival color at her upper anterior teeth. Great improvement of her lateral profile and diminishment of the dentoalveolar protrusion were achieved by orthodontic treatment. One- year follow-up records revealed good stability for both profile and occlusion.
延伸閱讀
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