開咬的終極頂級治療 Open Bite-The Ultimate Destination

    這是一位有歪斜、暴牙、開咬與下顎後縮，綜合非單一美觀問題的患者。初次看到這位患者，也許會優先想到拔牙，以取得空間來把牙齒排好。然而，優美和諧與對稱的顏面外觀，是我覺得最大的挑戰。

    The following patient actually has combined facial asymmetry, bimaxillary protrusion and small chin problems. Most doctors will think of extraction to align the teeth perfectly. However, the harmonized, balanced, and symmetrical facial profile is what I'm looking for in the first sight. Also, it's very challenge. 

    說到矯正設計，其實就是尋找最佳的鼻唇與下顎之間最好的相對位置。拔除小臼齒事實上是讓中線能對齊，然後將上下牙齒後移、上推。然而，改正咬合平面，與下顎骨的逆時針旋轉。更能讓上下牙齒後移量的情況改變，因為當更為協調的下巴曲線形成與更為立體的鼻唇角形成時，才是決定上下牙齒位置的主要因素。

    Talking abou the design of biomechanism, I'd say simply. It is how to find the best position to place the upper and lower dentition to the right position in terms of nose, lips and the chin. 

    Extraction is just making the space more usable for retraction and correct the midline. More importantly, is how to correct the occlusal plane and auto-rotate the mandible to make the bite differently. Also, the amount of retraction will also be different.  The reason is when the more prominent nasolabial angle and more beautiful lip-mental curve are developed; the perfect anterior teeth relationship then can be decided.