不明原因下顎髁頭吸收及齒列矯正合併正顎手術治療－－文獻回顧

Idiopathic Condylar Resorption: A Combined Orthodontic and Orthognathic Surgery Treatment Perspective — A Review Article

不明原因下顎髁頭吸收在齒顎矯正治療中雖不常見但卻容易被忽略，由於其漸進發展的特性，往往導致治療目標不能達成、成果不易維持，成為臨床矯正治療的難題。有些患者的症狀會在矯正治療前就出現，而有些會在治療中或是治療後出現，因此能夠及早診斷且告知病人風險，是矯正醫師應有的責任。本文將回顧文獻，首先探討不明原因下顎髁頭吸收的可能致病機轉及診斷，再進一步探討齒列矯正合併正顎手術治療的考量，以期臨床醫師在矯正治療中對不明原因下顎髁頭吸收有更進一步的瞭解，可以積極面對、與其他專科醫師一起處理協助病患，使他們得到合適的照護。

Idiopathic condylar resorption (ICR) is a well-documented but poorly understood progressive disease that affects the TMJ. ICR can result in malocclusion, facial disfigurement, TMJ dysfunction, and pain. Some cases occur spontaneously, whereas others appear during orthodontic therapy or as sequelae to orthognathic surgical procedures. It is essential for orthodontists to recognize the onset of ICR in patients as early as possible .This article discusses practical aspects of recognizing and managing ICR in orthodontic patients by a combination of orthodontic and orthognathic surgery treatment.