Yamasaki Y, Hayasaki H, Ogata T, Nakata M, Hamano Y
Department of Pediatric Dentistry, Kyushu University Faculty of Dentistry.
Shoni Shikagaku Zasshi. 1991;29(1):186-95.
We have been treating a girl with hemifacial hypertrophy since she was 5 years 8 months old. We analyzed her stomatognathic function, the dentition and occlusion, X-ray findings of TMJ, tooth contact and measurements of mandibular movement, at 9 years 2 months. The results were as follows: 1. The maxillary dental arch was almost symmetrical, but the mandibular one was complicatedly distorted in the up and down directions, and largely shifted to the left side. As a result the patient was able to occlude in the severe cross-bite condition of the area from incisors to left molars. 2. The patient had many tooth contact points on the right side and few on the left side when she bit at the intercuspal position and at the both lateral excursions. 3. From the analysis of the mandibular movements on the protrusion, lateral excursion and maximum open and close positions, it was suspected that the shift of right condyle was much less than the left one, and showed as almost rotating movement. 4. It could be concluded that the patient was accustomed to having more tooth contacts in the right dentition than in the left one because of the hypertrophy of the right half of mandible, so that she could only masticate with the right teeth also the anterior displacement of disk with reduction was resulted on the right condyle and the asymmetrical mandibular movement was noted.
我们从一名女童5岁8个月大时开始对其进行半侧颜面肥大的治疗。在她9岁2个月时，我们分析了她的口颌功能、牙列与咬合情况、颞下颌关节的X线检查结果、牙齿接触情况以及下颌运动测量结果。结果如下：1. 上颌牙弓几乎对称，但下颌牙弓在上下方向上严重扭曲，并且大幅向左偏移。结果，患者在从门牙到左磨牙区域处于严重的反咬合状态。2. 当患者在牙尖交错位以及双侧侧方运动时咬合，右侧有许多牙齿接触点，而左侧较少。3. 通过对下颌前伸、侧方运动以及最大开闭位运动的分析，怀疑右侧髁突的移位远小于左侧，且表现为几乎是旋转运动。4. 可以得出结论，由于下颌右半部分肥大，患者习惯右侧牙列比左侧有更多的牙齿接触，因此她只能用右侧牙齿咀嚼，右侧髁突还出现了盘状移位伴复位，并且观察到下颌运动不对称。
