第三級異常咬合矯正治療後的長期追蹤病倒報告一兩親生兄弟得到迴然不同的結果

Long-term Follow-up of Class 111 Malocclusion-Two Case Reports in Two Siblings with Different Treatment Outcome

前牙錯咬是臨床上常見的異常咬合，早期診斷與適時矯正治療很重要。由於前牙錯咬可能有多種骨骷顏面發展形態，有時無法從家族史及治療前的測顱分析數據，來準確預測額骨生長情形。可能要進行第二次的矯正，甚至需要正頓手術才能改善咬合及屏斗歪斜的外觀。本報告提出兩親生兄弟，在開始治療前有相似的咬合及外觀，經過矯正治療後長期追蹤，竟然發展成不同的咬合顏面形態，病患哥哥已經完成治療且追蹤穩定，弟弟卻需要接受正領手術才能改善咬合。因此我們建議對於骨幣還具有生長潛能，且已有異常徵兆者，就要先告知其未可預知之變化結果，並與病患及家屬溝通，決定是早期治療或等到骨幣發展趨於穩定後再進行治療，矯正後也需要長期追蹤上下頓骨發展形態，並擬定完整後績治療計劃，以達到最好的治療結果。Anterior crossbite is a common c lini ca l problem that requires early diagnosis and proper t reatment. Here we report on a pair of s iblings with anterior crossbite. They have a s imilar dental and facial profile at the start of treatment, but developed different types of dental facial patterns on follow-up. Our report highlights that it is difficult to precisely predict the facial growth simply based on patient's fami ly history and the data of cepha lometric analysis. Young patients with growth potential should be monitored continuou s ly after orthodontic treatment. Second orthodontic treatment or orthognathic surgery may sometimes be required to correct a severe dentofacial deformity.