上顎正中齒隙之矯正治療：病例報告

Orthodontic Treatment of a Case with Maxillary Midline Diastema

唐珮綺(Pei-Chi Tang) ； 林瑩澤(Yng-Tzer Lin)

《臺灣兒童牙醫學雜誌》 16卷3期 (2016/09) Pp. 94-100

https://doi.org/10.6319/TJPD.2016.16(3).2

摘要

上顎正中齒隙是在上顎正中門齒間有空隙，此空隙在乳齒列與混合齒列期仍可視為正常齒列轉換現象。除了正常齒列發展轉換現象，有不良的口腔習慣、肌肉軟組織不平衡、牙齒齒弓不一致、缺牙多生牙或牙齒大小異常、咬合不正、上顎唇區段的前突與顯著的唇繫帶等等。關閉正中齒隙，有賴於正確地診斷與治療造成該病例的成因與維持固位。本病例報告一位十四歲女孩其上顎正中門齒間有空隙約6mm。側顱分析屬於診斷是骨性二級異常咬合，伴隨著深咬與有一明顯強壯低位的唇繫帶。治療方法予以不拔牙進行全口矯正治療，關閉上顎正中齒隙，改正咬合不正關係與深咬。關閉上顎正中齒隙不久後，進行繫帶切除手術。前後歷經十六個月，完成時達到和諧的咬合及關閉的上顎正中齒隙。拆除矯正器後，以哈立維持器固位，後續四年的追蹤咬合仍然穩定，上顎正中門齒間隙沒有再次復發。

關鍵字

上顎正中齒隙 ； 唇繫帶

並列摘要

The maxillary midline diastema is a space between maxillary central incisors, which can be a normal transition from the primary to the mixed dentition. The possible causes of midline diastema after normal transition are oral habit, dentoalveolar disproportion, missing teeth, midline supernumerary teeth, proclination of the upper labial segment and a prominent frenum. The success in closing diastema relies on accurate diagnosis and treatment of the specific etiologies and effective long-term retention. We present a case of maxillary midline diastema 6 mm in a 14-year-old girl. Her diagnosis included a skeletal class II malocclusion with deepbite and a prominent frenum. Comprehensive fixed orthodontic appliances with non-extraction mechanics were used to correct her malocclusion. The midline diastema was closed followed by a frenectomy procedure. Ideal overbite and overject and resolution of the midline diastema were achieved within 16 months. Hawley retainers were used as a retention appliance. On the subsequent four-year follow-up, no recurrence of midline diastema was noted.

並列關鍵字

cleft palate ； cleft lip ； lip pits ； Van der Woude syndrome