- 期刊
成年人使用非手術性上顎擴張術之文獻回顧及臨床應用
Nonsurgical Maxillary Expansion in Adults-literature Review
摘要
上額的擴張（maxillary expansion）在早期矯正，被廣泛應用在治療兒童和青少年時期的後牙錯咬和擁擠。因為這段時期上顎弓的腭正中骨縫（midpalatal suture）尚未癒合，我們藉由上顎的擴張來打開腭正中骨縫，以此增加上顎的寬度和牙弓的長度，解決錯咬和齒列擁擠的問題。但是成年人他們的腭正中骨縫已經癒合骨化，我們除了藉由手術的幫忙來打開上顎弓，是否可用其他非手術的方式來解決此問題。本文在作上顎擴張的文獻回顧中，發現縱使是青少年時期，腭正中骨縫尚未癒合，真正可以打開腭正中骨縫的量，也只佔了整個上顎擴張量的40%~60%，所以有一半或一半以上的擴張量是由齒槽牙嵴的擴張和牙齒的往外傾斜所形成的。若將這治療理念應用在成人的上顎弓擴張，雖無腭正中骨縫的擴張量，但可以得到齒槽牙嵴的擴張量，因而達到同樣牙弓擴張的治療效果。最後提出一例作者用四環擴張器（quad helix appliance）治療一骨骼性三級咬合異常且合併上顎弓狹窄的臨床病例。
並列摘要
Early treatment with maxillary expansion has been recommended for child with transverse discrepancies, particularly unilateral crossbite, because it has been developed to skeletal asymmetries. It also routinely expanded early to relieve crowding, due to the middle palatine suture of maxilla can be open in the child and adolescence periods. As age increase, the middle palatine suture becomes more interdigitated, surgically assisted rapid maxillary expansion is necessary in adult. This article reviews treatment consideration, methods, appliances, mechanism, stability of nonsurgical maxillary expansion and how used in adult patient. We also present a clinical case to confirm quad helix appliance can treat maxillary narrowing of adult successfully.