三級異常咬合合併下顎正中線偏移及單側頰側錯咬之矯正治療

Orthodontic Treatment of Class III Malocclusion with Mandibular Midline Deviation and Unilateral Buccal Crossbite

周思婷(Szu-Ting Chou) ； 曾於娟(Yu-Chuan Tseng)

《中華民國齒顎矯正學雜誌》 16卷4期 (2004/12) Pp. 50-54

https://doi.org/10.30036/TJO.200412.0007

摘要

三級異常咬合病人常出現前牙錯咬問題，若再合併下顎正中線偏移及上顎後牙單側頰側錯咬，更增加其治療上的困難。本報告提出一則病例，針對病人(l)下顎正中線偏移的問題，使用不對稱對角彈線牽引(asymmetric diagonal elastic)來矯治；(2)前牙錯咬問題，則以配戴三級彈線牽引(Class Ⅲ elastics)配合閉合型弧線(closing loop)來矯治；及(3)上顎右側第二大臼齒頰側錯咬，則是以改良式後牙錯咬裝置(posterior crossbite appliance)，使右側臼齒產生下壓內縮及腭側移動之力量；而捨棄使用傳統常用之交叉橡皮圈牽引(cross elastics)，以避免臼齒產生過度挺出的副作用。不拔牙的情況下，經一年二個月的矯正治療，結果穩定且良好，包括對齊正中線及改正前牙錯咬、單側後牙錯咬問題，而臼齒關係亦達到安格氏一級咬合位置。

關鍵字

前牙錯咬 ； 後牙頰側錯咬 ； 三級異常咬合

並列摘要

Anterior crossbite is common in Class Ⅲ malocclusion patients. Treatment of Class Ⅲ malocclusion is even more difficult if it was combined of deviation of lower dental midline and unilateral buccal crossbite of upper posterior teeth. In this case report, a non-extraction therapy was presented, by use of (1) asymmetric diagonal elastics for correction of the deviated lower dental midline; (2) Class Ⅲ elastics in conjunction with closing loops for correction of the anterior crossbite; (3) modified posterior crossbite appliance for treatment of posterior buccal crossbite of upper right permanent second molar. Treatment time was one year and two months. The results were satisfied and stable, including the coincident dental midlines; anterior crossbite and posterior buccal crossbite were corrected; and Angle Class Ⅰ molar relation was achieved.

並列關鍵字

anterior crossbite ； posterior buccal crossbite ； Class Ⅲ malocclusion