Treatment of Anterior Open Bite, Left Molar Scissor Bite and Lower Arch Width Discrepancy in Primary Dentition

乳牙齒列前牙開咬、左側乳臼齒剪咬以及下顎牙弓徑不配合的治療

陳怡瑾(Yi-Chin Chen) ； 李俊育(Chun-Yu Li) ； 鄧乃嘉(Nai-Chia Teng)

《臺灣兒童牙醫學雜誌》 22卷1期 (2022/03) Pp. 76-85

https://doi.org/10.6319/TJPD.202203_22(1).0011

摘要

Scissor bite is one of the more unusual malocclusions in primary dentition. Early treatment of scissor bite has been advocated mainly to prevent functional jaw shift that can eventually lead to permanent skeletal asymmetry and temporomandibular joint pathosis. Persistent of long-time thumb sucking have been connected with increased overjet, decreased overbite, posterior crossbite, and anterior open bite. The purpose of this report is to discuss a case of 4 years 10 months boy of anterior open bite, left molar scissor bite and lower arch width discrepancy in primary dentition. This case was a 4 years 10 months boy diagnosed with posterior scissor bite of left side and lower arch width discrepancy combined with anterior open bite caused by the habit of thumb sucking. The Bluegrass appliance was used to maintain upper arch width and correct the habit of thumb sucking, while the William lingual expander was used to achieve lower arch expansion. After 6 months, the habit of thumb sucking was dropped, molar relationship was kept in mesial step with harmonic profile and occlusion. The Bluegrass appliance can be effectively used to correct thumb sucking habit. It is easy to fabricate and demonstrated good improvement of the dentoalveolar relationships. Scissor bite is one of the problems that need early intervention in primary dentition; otherwise, there are possibility that unsuitable growth and asymmetric development would have occurred in the oral-facial region, and dysfunctional occlusion might have developed in the mixed or permanent dentitions. When diagnosis and early treatment are properly carried out, normal occlusion can be achieved, which substantiates this case report.

關鍵字

Open bite ； scissor bite ； thumb sucking ； transforce appliance ； bluegrass appliance

並列摘要

剪咬是不常見的乳牙齒列不正常咬合之一。剪咬的早期介入治療主要是為了避免顎骨的功能性移動，以免產生骨骼性不對稱與顳顎關節病變。長時間持續的吸手指和水平覆蓋的增加、垂直覆蓋的減少、後牙錯咬以及前牙開咬有關。本病例為一4歲10個月大的男孩，診斷為左側乳臼齒剪咬、下顎牙弓徑不配合乳牙齒列以及因為吸手指習慣所造成的前牙開咬。使用Bluegrass裝置來維持上顎牙弓寬度以及改正吸手指的習慣，併行使用William舌側擴大裝置來擴張下顎牙弓。治療後六個月，吸手指習慣已戒除，而臼齒關係維持在近心咬合。Bluegrass裝置可以有效改正吸手指習慣，而且易於製作並顯示對於牙齒齒槽骨間關係有良好的改善。剪咬為建議早期介入治療的乳齒列不正常咬合之一。若不治療，可能在口面部分會有不對稱的發育，並在混合或永久齒列會有功能失調的齒列。當診斷及早期介入治療正確的實行，就可以達成正常的咬合。

並列關鍵字

開咬 ； 剪咬 ； 吸手指 ； 水平與垂直向的裝置 ； Bluegrass裝置