成人顏面不對稱單純矯正治療或合併正顎手術患者的形態特徵

Morphologic Characteristics of Adult Patients with facial Asymmetry Treated by Orthodontic Therapy or Orthognathic Surgery

曾于娟(Yu-Chuan Tseng) ； 歐凱捷(Kai-Chieh Ou) ； 潘金芸(Chin-Yun Pan) ； 周思婷(Szu-Ting Chou) ； 張宏博(Hong-Po Chang)

《中華民國齒顎矯正學雜誌》 23卷4期 (2011/12) Pp. 21-31

https://doi.org/10.30036/TJO.201112.0003

摘要

顏面不對稱是一項異常咬合患者常見的臨床特徵之一，掩飾性齒顎矯正治療能夠有效地矯治輕度甚至中度骨性顏面偏斜情形，至於嚴重的顏面不對稱可能需要正顎手術合併齒顎矯正治療才能予以改正。傳統測顱片雖為二維影像系統，但在診斷不對稱上仍是具有參考意義與價值的重要工具。本研究目的在於探討顏面不對稱成人病患採用單純矯正治療和矯正合併手術治療兩種不同治療計畫，在治療前齒顎顱顏結構的特徵與差異。選取顏面不對稱患者，分單純矯正治療組30人，以及矯正合併手術治療組30人，共60人。分別描繪其治療前之正面測顱X光片，利用傳統測顱分析方法，共採用11個標記點及51個測量項目，利用電腦軟體（Winceph®）測量，將測量結果進行雙樣本t檢定分析。結果顯示顏面不對稱矯正合併手術治療組，下顎骨左右不對稱性，不論在角度、寬度與比例上，差異性都比較大，也就是下臉都三分之一偏斜情形較為嚴重；上顎骨體左右寬度比例差異較大，左右牙弓寬度比例差異較大。結論：顏面不對稱患者，單純矯正治療組與矯正合併手術治療組，在齒顎顱顏上的確存在許多差異，這些顯著差異可提供臨床治療計畫擬定的參考。（J. Taiwan Assoc. Orthod. 23（4）: 21-31, 2011）

關鍵字

顏面不對稱 ； 正顎手術 ； 齒顎矯正治療

並列摘要

Facial asymmetry is a common feature in orthodontic patients. Mild skeletal facial asymmetry can be treated effectively by camouflaged orthodontic technique. Orthodontic treatment combined with orthognathic surgery would be suggested in some extreme cases of facial asymmetry. Although traditional posteroanterior cephalogram was 2D image, it was still full of reference meaning and value for diagnosing the asymmetric component in craniofacial area. The objective of this research was to investigate the differences in morphological characteristics of facial asymmetry patient who can be treated by orthodontic therapy only or combined orthognathic surgery. The pre-treatment postero-anterior cephalograms of two groups of 60 subjects (30 orthodontic and 30 surgical) with facial asymmetry were analyzed . Eleven landmarks and fifty-three angular and proportional measurements were made. Two sample t test was applied to identify the dentoskeletal variables that best separate the two groups. The findings of the study indicated that facial asymmetry patients with orthognathic surgery present with significantly mandibular asymmetric morphology in aspect of angles and linear proportions, larger linear dimensional proportion of the maxilla and arch width. However self-perception of frontal profile may be important factors affecting the patient's decision to opt for surgical correction. (J. Taiwan Assoc. Orthod. 23(4): 21-31, 2011)

並列關鍵字

facial asymmetry ； orthognathic surgery ； orthodontic therapy