- 期刊
The Two-Stage Non-Extraction Orthodontic Treatment and Outcome Assessment for Class Ⅱ, Division 1 Malocclusion with Excessive Overjet and Overbite-A Case Report
第二級第一類異常咬合伴隨過量垂直，水平覆蓋應用二階段不拔牙之矯正治療及結果評估－病例報告
摘要
第二級第一類異常咬合臨床上主要表徵為過量的水平覆蓋，前突的上顎門牙及下顎骨後縮，通常伴隨上下嘴唇無法自然閉合，因此上顎前牙外傷機會比其他型態之異常咬合機會高。第二級第一類異常咬合之治療方式包括生長導引、齒列掩飾骨性差異及正顎手術治療。在青少年時期，下顎生長形式是獲得良好治療結果的重要因素，藉由功能性矯正裝置誘導下顎往前往下生長，能有效地減少過量的水平覆蓋及改善顔面外觀，但日後仍需固定式矯正裝置以建立更好的咬合。 本病例報告描述一位具有第二級第一類異常咬合的11歲男孩，其異常咬合為過量水平覆蓋、深咬、下顎骨後縮。其治療方式即應用第一階段的Twin-Block來改善水平覆蓋，深咬及顔面外觀，第二階段進行不拔牙齒顎矯正治療。整體治療時間為3年並以PAR(Peer Assessment Rating) Index評估治療前後的變化及結果。
並列摘要
The patients with Class Ⅱ, division 1 malocclusion mainly possess increased overjet, proclined upper incisors, and retrognathic mandible. For those Class Ⅱ patients with incompetent lips, the risk of trauma to their maxillary incisor is more than that of the other malocclusions. The approaches to treat Class Ⅱ, division 1 malocclusion include growth modification, dental camouflage and surgical orthodontics. In adolescent patients, the mandibular growth pattern is significant factor to gain good result. To utilize the favorable growth pattern in terms of downward and forward direction by functional appliance in Class Ⅱ patients enables clinicians to successfully reduce the overjet and to improve the facial profile noticeably. Normally the occlusion after the functional appliance phase would still require fixed appliance to detail and settle the final occlusion. The case reported was an 11-year-old boy presenting with Class Ⅱ, division 1 malocclusion associated with excessive overjet, deep overbite, and retrognathic mandible. The patient was treated with Twin-Block appliance first to correct the main deteriorated clinical features, and non-extraction orthodontic fixed appliance treatment was thereafter applied. The treatment duration lasted for 3 years. The treatment changes were assessed by comparing the pre-treatment and post-treatment PAR (Peer Assessment Rating) index, and the outcome revealed the satisfactory result.
延伸閱讀
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