以正顎手術改善下顎前突與錯咬及復物改善咬合與美觀－病例報告

Using Orthognathic Surgery and Prostheses to Improve Esthetics and Occlusion of Skeletal Class Ⅲ Patient

黃筱婷(Hsiao-Ting Huang) ； 陳雅怡(Ya-Yi Chen) ； 陳柏勳(Po-Hsun Chen) ； 陳昱瑞(Yu-Ray Chen) ； 潘裕華(Yu-Hwa Pan) ； 吳婷婷(Ting-Ting Wu)

《中華民國齒顎矯正學雜誌》 23卷2期 (2011/06) Pp. 39-49

https://doi.org/10.30036/TJO.201106.0005

摘要

對於一個前牙錯咬合併下顎骨骼前突與偏移的第三類咬合異常的病患，以正顎手術配合傳統矯正來作治療時，正確的診斷及周詳的治療計劃是成功的要件。本報告病例是一位30歲的女性病患，主訴為下顎過長、國字臉以及牙齒顏色太深想做美觀上的改善。經過資料的收集與分析後，診斷病人為骨骼性第三類咬合異常伴隨下顎骨前突及向右偏移，矯正治療計劃為利用雙顎手術合併下頦整型術與下顎角削骨來增加上顎前牙露出的長度及改善下顎過長和下巴向右歪斜的問題。手術後的結果令人滿意，病人顏面美觀與咬合關係也獲得大幅改善。進而針對病人缺牙區做傳統牙橋復型，另外四環黴素造成的牙齒染色問題以全瓷冠和瓷牙貼片來做改善。

關鍵字

骨性第三級咬合異常 ； 正顎手術 ； 下頦整形術 ； 瓷牙貼片

並列摘要

Patient with class Ⅲ malocclusion and anterior crossbite combined with mandibular prognathism with deviation can be corrected through orthognathic surgery combined with conventional orthodontics. A proper diagnosis and careful treatment planning are the keys to success. This case report described a 30-year-old female, who complained of poor esthetics because of the square face and dark teeth. After a routine orthodontic examination, the diagnosis was skeletal class Ⅲ malocclusion with mandibular prognathism and a deviated chin shifted to the right. The treatment plan was 2 jaw orthognathic surgery combined with genioplasty and gonioplasty to improve the deficient upper incisal show, protrusive mandible and chin deviation.The orthodontic treatment outcome was very satisfactory. Then prosthodontic reconstruction of missing teeth and veneers to mask the dark anterior teeth were performed to improve esthetics and occlusion.

並列關鍵字

skeletal class Ⅲ malocclusion ； orthognathic surgery ； genioplasty ； veneer