面罩合併或不合併腭骨擴張器治療發育中之骨性三級異常咬合病患的中臉部幾何形態學分析

Morphometric Analysis of Changes in the Midface of Growing Skeletal Class Ⅲ Patients Treated with a Face Mask with or without the Combination of a Palatal Expander

張瑞青(Jenny Zwei-Chieng Chang) ； 劉保興(Pao-Hsin Liu) ； 姚宗珍(Jane Chung-Chen Yao) ； 陳羿貞(Yi-Jane Chen) ； 張志涵(Chih-Hang Chang) ； 張心涪(Frank Hsin-Fu Chang)

《中華牙醫學雜誌（中文版）》 1卷1期 (2005/03) Pp. 1-8

https://doi.org/10.7106/CJD.200503.0001

摘要

本研究的目的是要探討面罩治療合併或不合併腭骨擴張器對發育中骨性三級異常咬合患者在中臉部的治療療效。利用有限元素分析法分析患者治療前後的側面測顱X光片，除探討矯正者顱顏尺寸和形狀的變化外，亦分析骨骼受矯正力後主軸應變方向之變化。樣本選自歷年來曾在台大醫院齒顎矯正科接受過面罩治療，符合選取標準且資料完整的病例，其中單獨使用面罩組病例數為15位，使用面罩合併腭骨擴張組病例數亦為15位。控制組是來自一群長期追蹤未曾接受過矯正治療的骨性三級異常咬合年輕病患，以一對一的方式從中比對選擇和治療組的年齡、性別、追蹤時程，以及顱顏形態相符合者作為控制組。本研究可歸納以下結論：(1)以有限元素法探討面罩合併或不合併腭骨擴張在中臉部的治療療效發現兩組皆有局部的尺寸以及形狀上的變化。(2)單獨使用面罩治療組和使用面罩合併腭骨擴張組二者治療療效在統計學上雖然沒有明顯差異，不過合併腭骨擴張治療者牙齒的治療改變(dental effect)較小且在較短的時程內達到臨床上滿意的療效。(3)以有限元素分析法可以看出面罩合併腭骨擴張器對中臉部顱骨形態的影響有涵蓋比較廣泛區域的傾向，雖然這樣的型態差異在統計學上是沒有意義的。

關鍵字

面罩治療 ； 腭骨擴張器 ； 有限元素分析法 ； 主軸應變方向

並列摘要

The purpose of this study was to investigate the differences of the shape and size changes of the midface between the patients treated with face masks combined with and without palatal expanders by means of finite element analysis. Maximum and minimum principal extensions were drawn to express the directions of shape change. Thirty children who had been treated with face masks (15 combined with palatal expanders and 15 without) at the Orthodontic Department of National Taiwan University Hospital were compared with a group of thirty sex-matched, age-matched, observation period-matched, and craniofacial configuration-matched subjects with untreated Class Ⅲ malocclusions. It was concluded that: 1. the face mask treatment of the Class Ⅲ malocclusion with or without palatal expansion induced favorable localized size and shape changes in the midface region. 2. though statistically insignificant, combined face mask and palatal expansion therapy seemed to achieve satisfactory clinical results in shorter time and have less dental effects. 3. the treatment-induced changes of the face mask only group and the face-mask combined with palatal expander group did not differ significantly, but the face mask combined with palatal expander group tended to cause more extensive regional changes in the midface configurations.

並列關鍵字

face mask ； palatal expander ； finite element analysis ； principal extensions