- 期刊
Long-Term Treatment Outcome of a Class II Division 1 Malocclusion with Congenital Missing Maxillary Lateral Incisor
安格氏二級－咬合異常合併上顎側門齒先天性缺失治療之長期結果
摘要
Class II Division 1 malocclusion typically presents with increased overjet and proclined maxillary anterior teeth that seriously affect the esthetics of the patients. The incisor protrusion has been associated with increased risk of incisor trauma. The aim of this article is to illustrate the long-term treatment outcome of a Class II Division 1 malocclusion with congenital missing maxillary lateral incisor by three bicuspids extraction. The case report presents a 10-year-old female patient who suffered from a Class II Division 1 malocclusion and a congenital missing maxillary left lateral incisor. Treatment objectives were to correct the protruded maxillary teeth, to achieve adequate overbite and overjet, and to obtain a harmonious dental occlusion. Treatment was successful in the first two years, using comprehensive fixed appliance in reducing large overjet by extraction of maxillary right first premolar. The congenital missing tooth was substituted with canine by reshaping process with composite resin. After 13 years follow-up, crowding of lower dentition was noted. Therefore, treatment restarted with the goal for relieving crowding on the lower dentition by bilateral lower second premolars extraction. The long-term (17 years) result was successful in correcting of a Class II Division 1 malocclusion with congenital missing maxillary left lateral incisor into a normal balanced profile and occlusion. Early orthodontic intervention during mixed dentition and the second phase treatment for Class II Division 1 malocclusion has been recommended as a method for modifying skeletal growth, reducing treatment complexity, and reducing the incidence of incisor trauma.
並列摘要
安格氏二級一咬合異常典型表現過多的前牙水平覆咬及上顎前牙前突，嚴重影響患者外觀，亦增加門齒外傷風險。本病例闡述安格氏二級一咬合異常合併上顎側門齒先天缺失的長期治療結果。報告描述一名十歲女性患者，患有安格氏二級一咬合異常和單側上側門齒先天缺失，治療目的在改正上顎前牙過度前突，達到適當的垂直及水平覆咬，以及取得和諧的咬合。第一階段在拔除上顎右側第一小臼齒後，以全口固定式矯正器治療來改善過大的水平覆咬，左側缺失的側門齒以樹脂材料重塑之犬齒取代。十三年的長期追蹤，因下顎齒列變得擁擠而介入第二階段矯治，拔除下顎雙側第二小臼齒後以全口固定式矯正器治療來改善齒列擁擠。長期治療結果成功改善安格氏二級一咬合異常合併上顎側門齒先天缺失，達成和諧的外觀及咬合。對於安格氏二級一咬合異常的治療，建議在混合齒列期介入早期矯正治療以及後續二階段矯正治療，來改善骨性生長、降低治療複雜性，及降低門齒外傷的發生率。