◆ 口內檢查：

1. Midline: mandible shift to R't side about 3 mm
2. Arch form: U: symmetry V shape ...L: symmetry ovoid shape
3. Molar relationship: Right' ClassⅡ Left' ClassⅠ
4. Canine relationship: Right' ClassⅡ Left' ClassⅢ
5. Overbite:-1.6 mm(-22 %)
6. Overjet: 5 mm
7. Upper arch:
   ．1 mesioversion and mesio-buccal caries
   ．654 occlusal pit and fissure caries
   ．6 with occlusal AMF
   ．Anterior open-bite and L't side canine block-out
8. Lower arch: 65 56 occlusal pit and fissure caries

◆ 模型研究：

1. Bolton's analysis: anterior ratio: 74.5 % (reference : 77.2%) overall ratio:93% (reference : 91.3%)
2. Space analysis: upper:-2.1 mm lower:-3.8 mm

◆ X光檢查：

1. 1. panoramic: 6 AMF
   1 1 mesioversion
   3 high canine
   8 8 existed
   8 8
2. Cephalometry:
   

   Reference Pre-Tx Post-Tx SNA 81.5 + - 3.5° 84° 83° SNB 77.7 + - 3.2° 79° 76.5° ANB 4.0 + - 1.8° 5° 4° SN-MP 33.0 + - 1.8° 33° 32° UFH /LFH 45 % 55   49.6 % 50.4   46.2 % 53.8 U1-SN 108.2 + - 5.4° 115° 102° U1-L1 119.9 + - 8.5° 110.5° 124° L1-MP (M:96.8 + - 6.4)° (F: 93.7 + - 6.3)° 101° 98°

◆ 診斷： Dental ClassⅡsubdivision 1, Skeletal ClassⅠwith anterior open-bite

◆ 治療計畫及目標：

1. 改善前牙擁擠及嘴唇外翻的情況，得到較好的輪廓。
2. 戒除tongue-thrusting的習慣，防止矯正後的relapse
   治療方式：1. 4 4 extraction for decrowding and improving profile
   5 5
   2.6 6 banding and DBS, to level
   6 6
3. 3 3 tie-back for activation and then retraction
   4 4
4. Lower molar torque and tip-back
5. 3 3 retraction with closing loop and ClassⅢelastics
6. MEAW technique applied
7. 6 6 protraction
8. Final positioning and detailing
9. Muscle training of tongue and lip was recommonded