嚴重安格氏二級第一分類異常咬合之掩飾性矯正治療

Orthodontic Camouflage Treatment of Severe Class Ⅱ Division 1 Malocclusion-A Case Report

周思婷(Szu-Ting Chou) ； 張宏博(Hong-Po Chang)

《中華民國齒顎矯正學雜誌》 20卷3期 (2008/09) Pp. 32-39

https://doi.org/10.30036/TJO.200809.0005

摘要

安格氏二級第一分類異常咬合(ClassⅡ, division1)，其臨床特徵包括過大的門齒水平覆蓋(overjet)、極度唇側外翻的上顎門齒，同時下顎門齒常有過度萌出及舌側傾斜的情形。本報告提出一則嚴重二級第一分類異常咬合病例，由於其門齒水平覆蓋高達16.0mm，且合併先天缺失左下側門齒，更增加治療之困難性。治療計畫包括拔除上顎兩側第一小臼齒，在未使用骨釘或骨板等暫時性錨定裝置的情形下，僅以高拉式頭套(high-Pull J hook)及跨膠弧線(transpalatal arch)加弦錨定並後退上顎前牙。經三年二個月的矯正治療，獲得良好而穩定之結果，包括上顎門齒後縮11.0mm (U1-APo)、下顎門齒下壓內縮4.0mm及唇部輪廓明顯改善，臼齒關係則維持安格氏二級咬合位置。

關鍵字

安格氏二級第一分類異常咬合 ； 高拉式頭套

並列摘要

Clinical characteristics of Class Ⅱ division 1 malocclusion include excessive overjet, extremely labial-everted maxillary incisors, lingual-tipping and usually over-erupted mandibular incisors. This case report was about a severe Class Ⅱ division 1 malocclusion, with large overjet (16.0 mm) and congenital missing of lower left lateral incisor, which increased the difficulty of orthodontic treatment. Treatment plan was as follows: orthodontic camouflage therapy by extraction of bilateral maxillary first premolars only and use of high-pull hook and transpalatal arch for maximal anchorage during maxillary anterior retraction. Total treatment time was three year and two months. The results were satisfactory and stable, including 11-mm (U1-APo) distalization of upper incisors, 4-mm (li-XiPm) intrusion of lower incisors, and Angle Class Ⅱ molar relation was maintained.

並列關鍵字

Angle Class Ⅱ division 1 malocclusion ； high-pull J hook