軽度の上突咬合の開咬合、第三大臼歯萌出に伴って開咬合となったと判断された症例
治療担当者:与五沢 文夫 よごさわ歯科矯正
治療前 Before Treatment
顔貌
![顔貌](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-01.jpg)
![顔貌](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-02.jpg)
口腔内
![口腔内](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-03.jpg)
![口腔内](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-04.jpg)
![口腔内](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-05.jpg)
![口腔内](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-06.jpg)
治療後 After Treatment
顔貌
![顔貌](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-07.jpg)
![顔貌](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-08.jpg)
口腔内
![口腔内](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-09.jpg)
![口腔内](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-10.jpg)
![口腔内](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-11.jpg)
治療前 Before Treatment
治療方針
軽度の上突咬合の開咬合、第三大臼歯萌出に伴って開咬合となったと判断された症例。
すでに下顎左側以外の第三大臼歯は抜歯されているが、問診によると1991年に第三大臼歯を抜歯したが、同歯の萌出後に開咬合となったという。前歯部に咬毛跡がある。それほど強い舌癖は認められない(口腔内写真撮影時に舌が突出していないことからもわかる)。
下顎に時計方向への回転が起こり、開咬合に至ったと考えられたため、第一小臼歯4本の抜歯をおこないヘッドギアを使いながら下顎の反時計方向への回転を起こさせるようにして治療した。
顔貌
![顔貌](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-01.jpg)
![顔貌](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-02.jpg)
口腔内
![口腔内](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-03.jpg)
![口腔内](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-04.jpg)
![口腔内](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-05.jpg)
![口腔内](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-06.jpg)
模型
![模型](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-12.jpg)
![模型](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-13.jpg)
![模型](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-14.jpg)
パノラマ
![パノラマ](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-15.jpg)
治療後 After Treatment
顔貌
![顔貌](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-07.jpg)
![顔貌](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-08.jpg)
口腔内
![口腔内](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-09.jpg)
![口腔内](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-10.jpg)
![口腔内](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-11.jpg)
模型
![模型](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-16.jpg)
![模型](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-17.jpg)
![模型](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-18.jpg)
パノラマ
![パノラマ](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-19.jpg)
治療前後の比較(セファロの重ね合わせ)
黒ライン 初診時 1-28-’92
緑ライン 保定終了時 7-5-’97
![治療前後の比較(セファロの重ね合わせ)](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-20.jpg)
治療結果
咬合時に左右側とも第二大臼歯以外の歯牙の上下間での接触がない。
上下の前歯と犬歯に咬耗が認められるが、小臼歯部ではほとんど咬耗はない。
治療開始当初には、ヘッドギアとⅢ級の顎間ゴムを使用し、第二大臼歯の圧下をおこなった。
その結果、僅かではあるが下顎は反時計方向の回転を起こし前歯被蓋の改善に有利に作用した。
骨格形もしっかりして調和のとれた状態で、咬合は安定している。
治療経過 Progress
![2ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-21.jpg)
![2ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-22.jpg)
![2ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-23.jpg)
3-24-92 装置装着時 レべリング開始 上顎、下顎 .012” ラウンドワイヤー
![3ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-24.jpg)
![3ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-25.jpg)
![3ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-26.jpg)
4-21-’92 犬歯遠心移動開始
![4ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-27.jpg)
![4ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-28.jpg)
![4ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-29.jpg)
5-19-’92
![6ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-30.jpg)
![6ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-31.jpg)
![6ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-32.jpg)
6-16-’92 上顎、下顎 .014” ラウンドワイヤー
![7ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-33.jpg)
![7ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-34.jpg)
![7ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-35.jpg)
7-8-’92
![8ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-36.jpg)
![8ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-37.jpg)
![8ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-38.jpg)
7-28-’92
![9ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-39.jpg)
![9ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-40.jpg)
![9ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-41.jpg)
8-25-’92
![10ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-42.jpg)
![10ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-43.jpg)
![10ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-44.jpg)
8-31-’92
![11ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-45.jpg)
![11ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-46.jpg)
![11ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-47.jpg)
9-22-’92 治療開始後6ヶ月
![12ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-48.jpg)
![12ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-49.jpg)
![12ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-50.jpg)
10-20-’92 上顎、下顎、.016” ラウンドワイヤー 顎間ゴムならびにヘッドギアの使用開始
![13ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-51.jpg)
![13ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-52.jpg)
![13ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-53.jpg)
11-17-’92
![14ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-54.jpg)
![14ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-55.jpg)
![14ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-56.jpg)
12-15-’92
![15ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-57.jpg)
![15ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-58.jpg)
![15ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-59.jpg)
1-12-’93
![16ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-60.jpg)
![16ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-61.jpg)
![16ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-62.jpg)
2-8-’93
![17ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-63.jpg)
![17ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-64.jpg)
![17ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-65.jpg)
3-9-’93 治療開始後1年
![18ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-66.jpg)
![18ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-67.jpg)
![18ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-68.jpg)
4-6-’93 上顎 .018” × .025” 、下顎 .017” × .025” Vループアーチ
![19ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-69.jpg)
![19ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-70.jpg)
![19ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-71.jpg)
5-9-’93
![20ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-72.jpg)
![20ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-73.jpg)
![20ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-74.jpg)
6-7-’93
![21ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-75.jpg)
![21ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-76.jpg)
![21ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-77.jpg)
7-6-’93
![22ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-78.jpg)
![22ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-79.jpg)
![22ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-80.jpg)
8-14-’93
![23ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-81.jpg)
![23ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-82.jpg)
![23ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-83.jpg)
9-11-’93 治療開始後1年6ヶ月
![24ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-84.jpg)
![24ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-85.jpg)
![24ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-86.jpg)
10-9-’93 上顎 .018” × .025” 、 下顎 .017” × .025” アイデアルアーチ
![25ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-87.jpg)
![25ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-88.jpg)
![25ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-89.jpg)
11-9-’93
![26ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-90.jpg)
![26ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-91.jpg)
![26ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-92.jpg)
12-14-’93
![27ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-93.jpg)
![27ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-94.jpg)
![27ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-95.jpg)
1-12-’94
![28ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-96.jpg)
![28ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-97.jpg)
![28ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-98.jpg)
2-12-’94
![29ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-99.jpg)
![29ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-100.jpg)
![29ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-101.jpg)
3-9-’94 治療開始後2年
![30ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-102.jpg)
![30ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-103.jpg)
![30ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-104.jpg)
4-6-’94
![31ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-105.jpg)
![31ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-106.jpg)
![31ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-107.jpg)
5-10-’94
![32ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-111.jpg)
![32ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-112.jpg)
![32ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-113.jpg)
6-7-’94 上顎、下顎 .016” ラウンドワイヤーにて微調整をおこなう
![33ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-108.jpg)
![33ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-109.jpg)
![33ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-110.jpg)
7-6-’94
![34ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-114.jpg)
![34ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-115.jpg)
![34ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-116.jpg)
8-4-’94
![35ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-117.jpg)
![35ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-118.jpg)
![35ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-119.jpg)
8-29-94
![36ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-120.jpg)
![36ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-121.jpg)
![36ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-122.jpg)
9-26-’94 治療開始後2年6ヶ月
![37ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-123.jpg)
![37ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-124.jpg)
![37ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-125.jpg)
10-24-’94
![38ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-126.jpg)
![38ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-127.jpg)
![38ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-128.jpg)
11-14-’94
![39ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-129.jpg)
![39ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-130.jpg)
![39ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-131.jpg)
12-12-’94
![40ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-132.jpg)
![40ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-133.jpg)
![40ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-134.jpg)
1-9-’95
![41ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-135.jpg)
![41ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-136.jpg)
![41ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-137.jpg)
2-6-’95
![42ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-138.jpg)
![42ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-139.jpg)
![42ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-140.jpg)
3-8-’95 治療開始後3年
![43ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-141.jpg)
![43ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-142.jpg)
![43ヶ月目](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-143.jpg)
4-12-’95 装置除去2ヶ月前
![治療から5年4ヶ月](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-144.jpg)
![治療から5年4ヶ月](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-145.jpg)
![治療から5年4ヶ月](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-146.jpg)
7-5-97 保定終了時 治療開始後5年4ヶ月
保定 After Retention or During Retention
治療終了時 6-14-’95
保定終了時 7-5-’97
顔貌
![顔貌](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-147.jpg)
![顔貌](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-148.jpg)
![顔貌](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-149.jpg)
模型
![模型](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-150.jpg)
![模型](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-151.jpg)
![模型](https://yogosawa.org/wpyf/wp-content/themes/tandr/images/cases/view12-152.jpg)
患者情報
咬合分類とコメント | 開咬合 上突咬合 両突歯列 | ||||
---|---|---|---|---|---|
抜歯部位 |
|
||||
治療開始時年齢・性別 | 24歳7ヵ月 女性 | ||||
動的治療期間 | 3年3ヵ月 |