正顎手術重建成人患者複雜性齒顎異常－病例報告

Orthognathic Surgery for Rehabilitation of Adult Patient with Complicated Dentofacial Deformities-Case Report

謝育佳(Emma Yuh-Jia Hsieh) ； 柯雯青(Ellen Wen-Ching Ko)

《中華民國齒顎矯正學雜誌》 22卷1期 (2010/03) Pp. 28-38

https://doi.org/10.30036/TJO.201003.0004

摘要

本病例報告為一位32歲之成年女性患者，於四年前為了下顎復空間不足接受上顎雙側後方骨切除術，患者因仍感上顎前突而求診。患者口腔檢查呈現骨性二級異常咬合、上顎前方垂直過長、上顎咬合平面前後垂直差異與不對稱傾斜；口內多處缺牙及多組假牙復。為了達成改善顏面外觀與顎骨異常整體考慮之下，患者接受上顎勒福式第一型三段截骨術式合併雙側下顎骨矢狀劈開截骨術及頦成型術，最後再以齒列矯正建立咬合。術後顏面外觀及顎骨異常皆達良好改善，唯上顎咬合平面傾斜改善有限。本篇文章是將此結合齒列矯正及外科手術之複雜性齒顎異常病歷，其手術優先流程與顎間固定方式作一討論。

關鍵字

正顎手術 ； 成人患者 ； 齒顎異常

並列摘要

A case report is presented with a 32-year-old female patient who had received bilateral posterior segmental ostectomy of maxilla to create inter-occlusal space for mandibular removable partial denture 4 years before orthodontic first visit. She came for treatment with a chief complaint of maxillary protrusion. The patient presented skeletal Class II malocclusion with maxillary anterior vertical excess, occlusal plane cant with severe vertical discrepancy of maxillary arch, multiple missing teeth, as well as ill-fitted fixed partial dentures. For correcting of facial esthetics and severe skeletal discrepancies, the patient underwent surgical orthodontics with maxillary Le Fort I 3-pieces ostectomy, mandibular sagittal split osteotomy and genioplasty. The facial esthetic and skeletal discrepancies were improved after treatment, however the correction of occlusal plane cant was limited. The principle in surgery-first orthognathic approach and the intermaxillary fixation patient with complicated dental condition and jaw relation was discussed.

並列關鍵字

orthognathic surgery ； adult patient ； dentofacial deformities