咬合不正和顏面歪斜問題,長久以來被視為矯正治療最難處理的問題之一,多半必須尋求正顎手術協助,才能真正解決臉部的不對稱感。
近十年來,我面對不少手術改善歪斜問題的患者,得到許多的答案。矯正醫師可以改善咬合,手術醫師可以改善骨骼位置,而肌肉本身呢?或統稱軟組織本身,其實非常難以解決,肌肉的長短,力量大小,厚薄,與相對位置,常常使原本的歪斜在仔細觀察之下,依然存在,而此也常常讓醫師本身與患者困擾不已。
本文分享的案例為純粹的矯正治療,治療計劃中藉由上下顎牙齒的左右移動,改善中線問題,拔除小臼齒以創造空間。當有技巧性的改正外突門牙位置、笑容以及髮型的掩飾之後仍然帶來令人驚豔的效果!!
Facial asymmetry is one of the hardest problem in orthodontics. Most of the cases should be treated by orthognathic surgery combined with orthodontic treatment. However, the surgery part is also the major reason to make the patient to give up the whole regimen.
For 10 years of my career, I haver been seen many surgical and non-surgical cases with asymmetry. I got quite clear answers. The orthodontists can treat the occlusion to make it right. The surgeon can correct skeletal problem by cutting the bones. As for the soft tissue or muscle, however, it is the most difficult part to be resolved due to its different length of muscles, tones of muscles, thickness and its position attachment.
I tried to make the upper and lower teeth move in the opposite way to have the correct midline and it might need to take out the premolar. Most important thing of doing this is make the space for moveing all the front teeth backward to correct the protrusive profile. Finally the result turned out to be amazing, after great hair style was made to campoflage the asymmetry.
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