安格式三級不正咬合之合併正顎手術的矯正治療

The Combined Orthognathic Surgery of Orthodontic Treatment of Angle's Class Ⅲ Malocclusion

蔡吉陽(Tsai-Chi Yang) ； 鄭佳芬(Chia-Fen Cheng) ； 賴建志(Chien-Chih Lai)

《中華民國齒顎矯正學雜誌》 15卷1期 (2003/03) Pp. 56-64

摘要

在台灣常可以見到安格式三級不正咬合，除了前牙錯咬……等齒列特徵外，常常亦有上下顎骨之骨骼差異存在。不論是上下顎齒列、顎骨差異過大或是要改善顏面外觀時，皆無法單純只使用傳統矯正的治療方式而得到滿意的結果。本例為17歲女性之骨性下顎前突合併齒性代償及上顎齒列中線偏移的安格式三級不正咬合病例，在改正齒列中線及牙弓協調之完善的術前矯正後，採單顎之下顎後縮手術，並於術後立即使用垂直牽引式頦帽以及顎間橡皮筋之病例報告。所以具有完善治療計畫之合併正顎手術的矯正治療是一種相當理想的治療方式。

關鍵字

三級不正咬合 ； 正顎手術

並列摘要

In Taiwan, the prevalence of patients with skeletal Class Ill malocclusion is higher than that in Western population. If the skeletal discrepancy is too severe to be corrected by orthodontic treatment only, orthognathic surgery should be included in the ideal treatment plan. Not only the dental alignment, but also the patient 掇 facial profile will be corrected in the same time. This patient of the case report was a 17 years old female. Her chief complaint was mandibular prognathism. The diagnosis for this patient was severely skeletal Class Ill malocclusion with dental compensation. The treatment plan for this patient was orthodontic treatment combined with one-jaw orthognathic surgery. After the pre-surgical orthodontic treatment, mandi bular set-back with intraoral vertical ramus osteotomy was performed and immediately followed by vertical pull chin-cap with intermaxillary elastics. The final result of this treatment plan was good and this patient was fully satisfied. For the skeletal Class III malocclusion, the orthodontic treatment combined with orthognathicsurgery is an optional method and could bean ideal treatment for patients with severely skeletal discrepancy.

並列關鍵字

Class Ⅲ malocclusion ； othognathic ； surgery