- 期刊
以傳統錨定輔助雙顎前突之成人矯正治療－病例報告
Treatment of Bimaxillary Protrusion in an Adult Patient by Traditional Anchorage Control-A Case Report
摘要
在治療雙顎齒槽前突的病患時，錨定控制相當重要。近年來，骨內錨定裝置提供了絕對錨定效果，使得其使用率大幅提昇。然而，對於雙顎齒槽前突量中等程度且不樂意接受手術的患者，使用傳統性錨定控制便成為治療成功的關鍵因素。在此提出一例以傳統性錨定控制，治療雙顎齒槽前突的患者以供參考。患者為二十歲九個月的成人女性，因雙顎前突，而來院檢查要求治療，希望改善顏面美觀及咬合功能。經資料分析後發現，患者上、下唇閉合良好，側顏面呈現雙顎前突之外觀，上、下門牙垂直覆咬量為1mm，水平覆咬量為4mm，而左、右側第一大臼齒皆為安格式一級咬合關係。根據診斷資料，計劃拔除四顆第一小臼齒，並使用跨腭弓線提供錨定控制，進行全口矯正治療，來改善患者之咬合與外觀。經一年十個月完成矯正治療，患者擁擠之齒列已獲得改善，前牙水平及垂直覆咬皆為1.5mm，上下顎齒列密合度良好，大臼齒及犬齒皆為一級咬合關係，而因齒槽前突所造成之雙顎前突外觀也成功的獲得改善。由治療前後的測顱X光片重疊發現，患者上顎門牙有內縮及5mm後移，下顎門牙亦有內縮及後移；上、下顎大臼齒則約有3mm往前但無往咬合平面挺出之現象。由治療結果得知，單純使用跨腭弓線來提供錨定控制，並無法防止後牙水平前移，但是卻提供了良好的垂直控制，對於中等程度之雙顎齒槽前突病患，可用來提供良好的臨床治療效果。
並列摘要
Anchorage plays an important role for successful treatment of bimaxillary protrusion patient. A bimaxillary protrusion adult case, which was treated by fixed appliance combined with transpalatal arch, was presented in this report. This was a 20 year-old female who was diagnosed as skeleletal Class Ⅰ with bimaxillary protrusion. After four first bicuspids were extracted, she was treated by fixed appliance combined with transpalatal arch in the maxilla as anchorage. The patient showed Class Ⅰ molar relationships with good interdigitation after 22 months orthodontic treatment. Cephalometric superimposition demonstrated maximum retraction of the anterior teeth with mild anchorage loss. The results indicate that transpalatal arch is excellent for vertical control, but not good enough for anteroposterior anchorage control. For adult patient with woderate bimaxillary protrusion, transpalatal arch is effective for both vertical and anteroposterior anchorage control.