- 期刊
以非手術方式對合併有垂直高度減少與多重缺牙之骨性三級異常咬合的矯正治療
Nonsurgical Orthodontic Treatment of a Skeletal Class Ⅲ Malocclusion with Reduced Vertical Dimension and Multiple Missing Teeth
摘要
傳統上對成人骨性三級異常咬合的治療，常以正顎手術或補償性的牙齒矯正方式處理，這類病人若合併有垂直高度減少會增加診斷與治療的複雜性。本病例報告一位合併垂直高度減少之三級異常咬合的成人女性，其垂直高度減少的主因，為多重缺牙與臼齒傾倒導致的咬合過度閉合，故治療計劃以非手術性矯正方式恢復適當的垂直咬合高度。治療過程主要將傾倒的臼齒扶正，牙弓調整重建一平坦的咬合平面與適度的垂直高度。治療結果垂直高度適度被提高，上、下顎骨矢狀方向的差異有改善；上下門牙角度無很大的牙齒補償變化，且水平覆蓋達到正值關係；治療後顏面外觀變得較直且協調。由本病例報告得知類似的病例若能經過審慎的診斷與適當的治療計劃，將可以非手術性的方式達到協調的治療結果。
並列摘要
Generally, for cases of skeletal Class III malocclusion, orthognathic surgery or dental compensation is the treatment of choice. Furthermore, diagnosis and treatment planning in such cases is complicated if reduced vertical dimension is also present. The case reported was an adult female presenting skeletal Class III malocclusion combined with reduced vertical dimension, in which the etiology of reduced vertical dimension was found to be mandibular overclosure caused by multiple missing teeth and tipped molars. Therefore, we planned to restore vertical dimension of occlusion by nonsurgical orthodontic treatment. Through molars uprighting, aligning and leveling of dental arch, a flat occlusal plane and appropriate vertical dimension of occlusion were restored in the course of treatment. The treatment resulted in decreased intermaxillary discrepancy in sagittal plane through increasing vertical dimension. There was no significant dental compensation in incisors angulation and a positive overjet was achieved. A more straight and harmonic facial profile was attained after orthodontic treatment. It could be derived from this report that through cautious diagnostic evaluation and treatment planning, conservative nonsurgical orthodontic treatment might have satisfactory result in similar cases.