齒顎矯正合併正顎手術治療骨性三級咬合異常－－病例報告

Orthodontic – Orthoganthic Management of A Skeletal Class III - A Case Report

三級咬合異常的成年病人的治療方式包括單純矯正治療或是搭配正顎手術治療。對於需要手術的病人來說，美觀是相當重要的。手術的方式包括將上顎往前（Maxillary advancement）、下顎後縮（Mandibular setback）、或者雙顎手術（%LPD[LOODU\RVWHRWRP\）。本病例中病患是一個17歲的女性，診斷是骨性三級咬合異常伴隨前牙錯咬以及開咬，並且有較嚴重擁擠的現象。治療的計畫包含矯正搭配正顎手術治療，治療過程中拔除四顆的第一小臼齒以及上顎兩顆第二大臼齒。治療中也有使用矯正迷你植體來幫助上下顎牙弓相符合。治療後達到雙側臼齒以及犬齒都呈現一級咬合關係，並達到良好的外觀。

Treatment of Class III malocclusion in non growing patients usually involves either orthodontic camouflage or orthognathic surgery (OgS). Aesthetic outcome has gained in importance in the treatment of orthognathic patients. The surgery options of Class III malocclusions have historically been treated by isolated mandibular setback and maxillary advancement, or bimaxillary osteotomy. This is a case of 17-year-old female patient with skeletal Class III with mandibular prognathism, anterior crossbite and open bite, and severe crowding. Treatment plan included orthodontic treatment with orthognathic surgery, extraction of four first bicuspids and upper bilateral second molar due to poor position and inclination. We also use temporary anchorage device (TAD) for arch coordination. The final result was bilateral canine and molar Class I relation and balanced profile.