雙顎前突患者齒顎顏面形態特徵的探討

Characteristics of Dentofacial Morphology in Bimaxillary Protrusion Patients

陳瓊鈺(Chiung- Yu Chen) ； 張宏博(Hong-Po Chang) ； 楊奕馨(Yi-Hsin Yang) ； 曾于娟(Yu-Chuan Tseng) ； 潘金芸(Chin-Yun Pan) ； 周思婷(Szu-Ting Chou)

《中華民國齒顎矯正學雜誌》 25卷2期 (2013/06) Pp. 68-82

https://doi.org/10.30036/TJO.201306_25(2).0001

摘要

目的：雙顎前突外貌的不美觀，常會對患者造成社會及心理層面的困擾。本研究目的在於探討雙顎前突患者之齒顎顱顏形態特徵，進而幫助臨床上的診斷與治療計畫的制定。方法：選取雙顎前突之成年男女各30名，並選取正常咬合之成年男女各30名，分別描繪其側面測顱X光片，利用測顱分析法，共採用32個標記點及61個項目，再進行測量項目單變項分析與二因子變因數分析。結果：雙顎前突者呈現骨性二級關係，上顎骨長度較長且較前突，下額骨總長度較長但矢向位置與正常咬合組間沒有統計差異存在，且下顎骨有順時針旋轉的情形，頦部較後縮，同時咬合平面也較傾斜：顏面開展度較大，前臉部高度較長，以前下臉部的差異為主。齒列方面，雙顎前突者的上下顎門牙較前傾且前突，上下顎門牙齒軸角較小，且垂直高度較大：上下顎第一大臼齒角度較直立，矢向位置較前，同時垂直高度也較大。結論：雙顎前突患者在齒顎顱顏形態上確實存在不同於正常咬合者的特徵。

關鍵字

雙顎前突 ； 異常咬合 ； 測顱分析

並列摘要

Objective: Dentofacial abnormalities, such as bimaxillary protrusion, can be distressing both socially and psychologically. The aim of this study is to identify the cephalometric features of bimaxillary protrusion and highlight the measurements that characterize bimaxillary protrusion when compared to a normal occlusion group. Materials and methods: Lateral cephalograms of 60 pretreated bimaxillary protrusion young adults were compared with 60 untreated young adults with normal occlusion. Male and female were equal in each group. Thirty-two landmarks were identified for 61 skeletal, dental and soft tissue parameters. The differences between the two groups were analyzed by means of Student's t-test and two-way ANOVA. Results: There were morphological features in the bimaxillary protrusion group. In the bimaxillary protrusion group, the sagittal jaw relationship was skeletal Class ”condition with increased ANB. The maxilla was found to be more prognathic in the bimaxillary protrusion group and the length of the maxilla was significantly longer than the controls. There was no significant difference in the sagittal position of the mandible between the two groups. The mandibular plane angle was more obtuse with downward and backward rotation. The chin was more retrusive on the bimaxillary protrusion group. Divergent facial pattern was found in the bimaxillary protrusion group with longer lower anterior facial height. The maxillary and mandibular incisors were proclined and protrusive, and the interincisal angle was smaller than the controls. The sagittal positions of maxillary and mandibular first molars were more protrusive with more upright angulation. The vertical position of the incisors and first molars were longer than the controls. Conclusion: The characteristics of dentofacial morphology in bimaxillary protrusion group do differ from those in normal occlusion group.

並列關鍵字

bimaxillary protrusion ； malocclusion ； cephalometric analysis