利用迷你骨釘配合下顎手術有效改正臉部歪斜

Treatment of Facial Asymmetry by Mini-Implants Combined with One-Jaw Surgery

王亞婷(Ya-Ting Wang) ； 王剛毅(Kang-Yee Wang) ； 章浩宏(Hau-Hueng Chang) ； 姚宗珍(Chung-Chen Jane Yao)

《中華民國齒顎矯正學雜誌》 22卷1期 (2010/03) Pp. 39-46

https://doi.org/10.30036/TJO.201003.0005

摘要

臉部歪斜可能是生長時源自於下顎前後向及垂直向的不對稱，進一步造成上顎垂直向代償性的咬合平面歪斜。在過去骨性錨定尚未蓬勃發展的時代，改變這類病例臉部歪斜的問題，必得使用雙顎手術。但在今日，先利用骨性錨定將過度萌發的上顎臼齒壓入，整平傾斜的咬合平面，可使手術計畫簡化為單顎，整體的治療經費大幅度減少，而所須花費的時間也不會多太多，是個相當不錯的選擇。
本病例報告患者為30歲女性，主訴為臉部歪斜，臨床診斷為安格式一級不正咬合，除了下頷向左偏斜，同時也伴隨著右邊咬合平面向下傾斜。治療過程中先利用骨釘、骨板將過度萌發的右上齒列壓入，改正咬合平面傾斜，再配合下顎手術將歪斜和微前突的問題一次改正，獲得對稱、賞心悅目的外貌和整齊、良好的咬合關係，整體治療時間為17.5個月，病人對整體治療結果很滿意。另外，本報告將討論骨性錨定在此類病人手術準備上的幫助。

關鍵字

臉部歪斜 ； 咬合平面傾斜 ； 正顎手術 ； 迷你骨釘

並列摘要

Facial asymmetry may originate from mandibular deviation combined with secondary maxillary compensation in vertical dimension, which can lead to occlusal plan canting. Two-jaw surgery would be an ideal choice for these cases in the past. Nowadays, using mini-implants to intrude elongated maxillary teeth to correct the occlusal plane canting could simplify the surgical plan into one-jaw surgery. In this case, a 30 y/o female was diagnosed with skeletal Class I malocclusion with mandibular deviation to left side combined with occlusal plane canting. The canted occlusal plane was corrected by intrusion of upper right posterior teeth with miniplate and minisrew first, and then one-jaw surgery for side shift and setback of mandible was performed. It took 17.5 months to have symmetric and pleasing facial profile, and good dental relationship. The patient was satisfied with the treatment outcome. Benefits of mini-implants application in pre-orthognathic surgical preparation are reviewed and discussed.

並列關鍵字

facial asymmetry ； occlusal plane canting ； orthognathic surgery ； mini-implants