成人骨性三類異常咬合的掩飾性矯正治療－－病例報告

Camouflage Orthodontic Correction in an Adult Patient with Skeletal Class III Malocclusion – A Case Report

此病例報告提出一成年骨性三類異常合併前牙錯咬、開咬傾向及齒列擁擠之掩飾性矯正治療。一位 19歲男性前來求診，主訴是前牙擁擠。臨床檢查顯示患者側面觀為直偏凹臉型、中臉部扁塌、下顎前突、下顎平面角度偏高、雙唇前突及嘴唇閉合不全，咬合呈現安格式三級異常咬合。在病患拒絕正顎手術治療的狀況下，掩飾性矯正治療計畫為拔除上顎兩側第二小臼齒及下顎兩側第一小臼齒並合併適度的下顎骨後下旋轉，以改善顏面外觀及咬合關係。治療結果顯示臉部外觀的改善及一級咬合關係的達成。本篇亦就成人骨性三類異常咬合相關的治療策略、掩飾性矯正治療及錨定控制作相關探討。

The case report described the camouflage treatment of an adult patient with skeletal Class III, anterior cross bite, open bite tendency and dental crowding. A 19-year-old male patient presented with chief complaint of anterior crooked teeth. The clinical examination showed a straight to concave profile, midface retrusion, mandibular protrusion, slightly high mandibular plane angle, upper and lower lip protrusion, lip incompetence, Class III molar and canine relationships. Because the patient refused to receive orthognathic surgery, the camouflage orthodontic treatment was planned along with extraction of bilateral upper second premolars and lower first premolars and modest backward-rotation of the mandible to improve facial esthetics and occlusion. The treatment results showed improvement of facial appearance and achievement of Class I molar and canine relationships and satisfactory occlusion. The treatment strategies of adult skeletal Class III, considerations in the conception of camouflage orthodontics and anchorage control were discussed.