許多醫療個案的媒體報導，當下或許引人注意，但是後續治療成效如何？經常是不得而知。
2007年8月，我們曾報導一位戽斗的洪同學，國小時經過第一階段面罩式下頷矯正頭套 (Face Mask / 又稱反拉式矯正頭套Reverse pull Headgear)，將上頷前拉(protraction)，改善門牙錯咬狀況後，國中時再接著進行第二階段固定式牙套矯正治療。
由於患者齒列擁擠，因此第二階段是以拔除小臼齒，進行固定式牙套矯正治療。治療結果當然是齒列整齊、咬合穩定，患者戽斗的外觀也得到改善。
因為患者家長非常注意孩子齒列的咬合狀況，因此患者每年都回來門診追蹤檢查。今年是第十二年，除了下顎稍微有增長之外，咬合大致穩定。人類的下顎生長發育十八足歲之後就算停止，所以洪媽媽很高興沒有正顎手術的煩惱！
有些意見是認為小時候不用作矯正治療，等長大再做矯正手術即可，這是錯誤的觀念，因為，牙齒咬合問題會引起消化方面的問題，對於身體健康有一定的影響，至於骨骼前後關係差異嚴重的戽斗患者，兩階段齒列矯正有時候無法完全矯正過來，雖然還是小戽斗，但成年後的正顎手術會比較簡單，顏面外觀亦較佳！故戽斗患者仍然值得接受早期矯正！
Abstract
[Objective] The incidence of Angle Class III malocclusion in Taiwan is about 3~5%. The most common reason for their parents seeking orthodontic treatment is anterior cross bite. For early orthodontic treatments, face-mask or chin–cap or some removable appliance were often suggested. An Angle Class III boy with anterior cross-bite was treated with face-mask in Phase I then using fixed appliance to complete Phase II treatment. And a 13-year long term follow-up result will be discussed.
[Case] Clinically it is not uncommon to see young patients with anterior cross-bite. Early orthodontic Phase I treatment was often recommended. Treatment of choices included face-mask or chin–cap or some functional appliance. This case report described the treatment for a 10 year-old boy who has Angle Class III malocclusion with anterior cross-bite. The treatment plans included: Phase I therapy with face-mask, and Phase II treatment with fixed appliance.
[Discussion] After 1 year of face-mask treatment, the anterior cross-bite was corrected and satisfactory profile change achieved. Owing to moderate crowding, Phase II treatment completed with Class I occlusion after four first premolar extraction via fixed appliance. (Treatment changes—SNA: 78 °to 80°; SNB: 79 °to 78°; ANB: from -1°to 2°; Maxilla CCW rotation, palatal plane & functional occlusal plane flattened). And the 13-year post-treatment long term follow-up outcome showed that the occlusion maintained well except slight mandible forward growth.
[Conclusion] It is pertinent for orthodontists to apply early orthodontic treatment for Angle Class III children. Once the anterior cross-bite has been corrected, the mandibular growth may be guided into a more favorable pattern. And hopefully, the achieved occlusion could be maintained into adulthood.
以上為李慈心醫師矯正案例與撰文，如民眾想進一步了解青少年兒童矯正，歡迎預約李慈心醫師門診進一步了解。