為什麼矯正要取這麼多資料？

1728 年，被譽為「現代牙醫學之父」醫生皮耶·費查，出版了第一本關於牙醫學的完整科學書籍《外科牙醫學》。在書中，他使用一種叫做＂Bandeau＂的矯正器，長得像馬蹄狀，固定在齒列中，用來矯正擴大牙弓，算是牙齒矯正的始祖。矯正發展到現在300年，經過很多學者的努力，已經可以很系統性的利用取得的資料去評估這位患者有哪些需要改善的地方。了解哪些需要改善的地方，才能讓矯正醫師在矯正時對症下藥，不至於走錯了方向。

另外藉由測顱Ｘ光片的分析，也較容易發現咬合不正的原因是因為齒性的關係還是骨性的關係造成，如果是骨性造成的齒列不整，就可能需要正顎手術的評估與介入，需要手術醫師與矯正醫師的互相配合。

隱適美矯正前評估需要哪些資料？

通常隱適美矯正前，需要取下列資料來進行矯正前的評估：

1. 主訴的了解，外觀與口內的臨床評估
2. 口內數位掃描檔
3. 口外照，包含正面照、正面微笑照及側面照共3張
4. 口內照，包含上下顎、正面與左右咬合關係共5張
5. 測顱Ｘ光片
6. 全口環景Ｘ光片
7. 正顱Ｘ光片（非必須）
8. CBCT牙科斷層掃描（非必須，但是越來越多醫師使用）

矯正評估的費用？

以黃醫師自己的習慣，矯正評估分為兩個階段，第一階段粗略評估階段與第二階段詳細評估階段，第一階段需掛號費，第二階段則會收取資料收集的費用。

第一階段是矯正評估表和itero口內數位取模，並會粗略模擬矯正結果，第一階段目前只收掛號費也需要先預約。第一階段可以讓患者大略知道自己的狀況，以及經由itero數位取模，模擬後大約知道自己矯正後牙齒的狀況，這時候得到的治療計畫是比較粗略的。

第二階段評估則是會取較多的資料，包含：口內口外照、測顱X光片、全口環景Ｘ光片、CBCT牙科斷層掃描。這部分會收取資料收集費用，之後黃醫師會對測顱X光片做測顱分析，並將資料送交隱適美待完整治療計畫撰寫完畢再約時間一起討論你的治療計畫，這時候就可以得到精確的治療計畫。

第一階段矯正粗略評估階段

矯正評估單

通常第一次來做簡單評估的患者，黃醫師都會請櫃檯拿出一張矯正評估單給患者填寫。這張評估表通常是由患者與醫師協力完成。

這張評估表的用意主要是希望先了解你的主訴，之前有沒有相關矯正經驗或是家族中有沒有和您類似的相關牙齒問題，像是戽斗就容易有家族性遺傳的問題，這些都是隱適美矯正前需要先了解的。除了了解主訴之外，接下來就是對軟組織外觀，及口腔內咬合狀況做一個詳細的紀錄，除了幫助醫師了解口腔狀況外，患者也能對自己的狀況有一個粗步的了解。

Itero 數位取模與矯正結果模擬

隱適美矯正有自己專屬的數位掃描機Itero，Itero好處是口掃印模之後，可以直接當次模擬隱適美矯正後的大概牙齒排列。圖左為隱適美矯正前，圖右為模擬隱適美矯正後，由於隱適美矯正取模是3D建模，可以經由360度的旋轉讓你看清楚你原本牙齒的正面觀、側面觀、咬合面觀，方便醫師跟你講解你目前牙齒發現的問題，另外經由電腦的粗步模擬，也可以讓你了解隱適美矯正後的牙齒排列，會比一般只觀看類似病例的照片來了解自己矯正後的樣子來的直觀。

第二階段矯正詳細評估階段

正面與側面的口外照

由於不太方便大咧咧的把患者臉部照片曝光，這裡以卡通圖代替。

正面的口外照主要是評估上中下臉部的比例，另外也會觀察顴骨的高低，對臉部軟組織表現的影響。側面的口外照主要是看鼻子的挺拔程度，還有鼻唇角，嘴形是否有暴牙。正面的微笑口外照則是用來評估微笑曲線，評估門牙的位置及牙齒排列的弧度在露齒笑的時候是否適中，是否需要調整。

現在矯正的大方向是由軟組織來決定牙齒的移動方向，所以觀察患者的臉部外觀通常是矯正的第一步，另外也希望藉由觀察後進一步的溝通來了解患者自己對於矯正的想法。

正面、側面與上下顎口內照

除了紀錄一開始未開始隱適美矯正前的牙齒狀態，也可以核對口內數位掃描時的咬合正不正確。照片的目的在於幫助醫師發現咬合的問題，並可以再次回頭確認一開始的矯正評估單紀錄是否有分歧，及數位掃描時取的咬合位置正不正確。

通常在照片階段，醫師會去觀察牙弓的形狀，犬齒與第一大臼齒的上下顎關係，牙齒擁擠的程度。

側顱Ｘ光片

側顱分析是矯正評估中很重要的一環。矯正發展至今，Ｄowns、Steiner、Tweed各個在矯正中佔有一席之地的學者大師都發展了自己一套的測量系統，利用統計的方式計算出各個指標中的平均值與標準差。側顱分析就是在測顱Ｘ光片上以解剖位置為點，連成很多條線，來計算角度及距離是否在正常範圍內。

通常取完精細資料的下次約診，黃醫師就會出具一份測顱分析報告給你，告訴你你的咬合分級還有我們在Ｘ光上發現的問題是什麼。

環景Ｘ光片

主要是來確定牙齒的狀況，跟一般定期檢查一樣，矯正前要先確認蛀牙、牙周病、假牙、阻生牙的狀況，這些狀況在矯正前都需要先治療完畢，才能正式進入隱適美矯正階段。

CBCT牙科電腦斷層掃描

現在牙科電腦斷層越來越普及下，許多矯正醫師在隱適美矯正前也會額外拍攝牙科電腦斷層掃描。和環景Ｘ光片不同，斷層掃描是3D的影像，主要是用來評估牙齒周圍的骨頭足不足夠，在牙齒移動過程中會不會有齒槽骨穿孔的問題。

近期(2022.10)隱適美矯正公司也更新了他們的軟體，加入了斷層掃描這一塊，藉由口內數位掃描檔與斷層掃描檔的結合來生成含有齒槽骨的牙齒3D圖，幫助醫師在設計牙齒移動的過程中更能掌握牙齒與骨頭的狀況。可以想見的是之後將斷層掃描加入矯正前評估的醫師會越來越多。

• 你可能想了解：隱適美與一般傳統矯正的差異？

Can I use Invisalign? How is it different from traditional braces? What are the four types of people who are suitable for Invisalign?

各種不同類型的矯正 Different Types of Orthodontic Correction

當你鼓起勇氣準備要開始諮詢矯正，卻被很多矯正的名詞搞得一頭霧水嗎？為什麼矯正又有分「舌側矯正」，「傳統矯正」、「隱形矯正」的差別？這篇我們先來了解所謂的「傳統矯正」跟「隱形矯正」是什麼？差別又在哪裡？

Are you feeling confused by the various terms used in orthodontics when you are gathering the courage to consult for orthodontic treatment? What is the difference between “lingual braces,” “traditional braces,” and “invisible aligners”? In this article, we will focus on understanding what “traditional braces” and “invisible aligners” are, and how they differ.

傳統矯正 Traditional Braces

矯正發展的歷史很早，大約是1880年開始就有矯正的理論及治療，初期都是以鐵環跟鐵線綁在牙齒上做治療，隨著材料的進步，演變至現在各位看到黏在牙齒上的金屬矯正器及鐵線，一般稱為傳統矯正。

Orthodontics has a long history of development, with theories and treatments dating back to around 1880. Initially, treatment involved using metal bands and wires to bind around the teeth. With material advancements, it has evolved into what we now call “traditional braces,” which involves attaching metal braces and wires to the teeth.

隱適美隱形矯正 Invisible Aligners

『隱適美』則是最早開始施行隱形矯正的公司，在1997年便開始隱形矯正的業務，發展至今成為全球最大隱形矯正公司。不同於傳統矯正，隱適美主打舒適與美觀，是以透明成型片來包住牙齒，進而達到移動牙齒的目的。

“Invisalign” is the company that pioneered the use of invisible aligners, beginning in 1997, and has since become the largest invisible aligner company globally. Unlike traditional braces, Invisalign emphasizes comfort and aesthetics by using clear aligners that wrap around the teeth to achieve tooth movement. 

矯正原理 Principle of Orthodontic Treatment

不管是「傳統矯正」、「舌側矯正」還是「隱形矯正」，在牙齒移動的原理上是一樣的：對於牙齒施加一個輕微且持續的力量，齒槽骨受力那側會因受力而吸收，對側的齒槽骨則會生成新的齒槽骨，齒槽骨一增一減就可以讓牙齒往牙醫師需要的方向做移動。雖然原理是一樣的，但是傳統矯正與隱適美隱形矯正兩者在診斷過程還有配戴體驗還是有差異。下面大叔會細分成9項的表格來比較，讓各位瞭解差別在哪裡，進而知道自己的需求。

Whether it’s “traditional braces,” “lingual braces,” or “invisible aligners,” the principle of tooth movement is the same: applying a light and continuous force to the teeth, causing the alveolar bone to absorb on the side of force and generate new alveolar bone on the opposite side, resulting in tooth movement in the direction desired by the orthodontist. Although the principle is the same, there are differences in the diagnosis process and wearing experience between traditional braces and Invisalign. The following table will be used to compare and highlight the 9 differences between the two, allowing you to understand where the differences lie and determine your own needs.

隱適美與傳統矯正的比較 Comparison between Invisalign and Traditional Braces

外觀 Appearance：

隱適美是利用可拿上拿下的透明片使牙齒移動，所以在配戴時拍照不易被發現，更可以在重要場合時先將牙套拿下，對外觀的影響減至最低。

傳統矯正則是利用金屬矯正器黏著在牙齒上，微笑時容易被看見，不論拆卸都需由醫師花時間做處置，雖然現在有比較不影響美觀的陶瓷矯正器，但是一樣會使用金屬的矯正線，如果對於美觀有強烈需求的人會有點困擾。

Invisalign uses transparent, removable aligners to move teeth, making it difficult to notice when taking photos and reducing the impact on appearance, especially in important events.

Traditional braces, on the other hand, use metal brackets and wires that are visible when smiling and require time-consuming adjustments by a dentist when removed. Although there are now ceramic braces that are less noticeable, they still use metal wires, which can be problematic for those with strong aesthetic concerns.

舒適度 Comfort:：

讓我們先從矯正時，牙齒上的黏著物來比較。傳統矯正會在牙齒上黏上矯正器，隱適美則是會黏上小豆豆。傳統的金屬矯正器大小比小豆豆大得多，所以初期會有容易刮傷嘴唇，造成粘膜破皮的狀況。

另外傳統矯正在每次換線時的不舒服感也比隱適美每次替換牙套的不舒服感來得多，大叔自己有被做過傳統矯正，永遠忘不了有一次剛換完線要吃薯條完全咬不動，只能用口水先將薯條浸軟再咬的狼狽狀況。

Let’s start by comparing the adhesives used on teeth during the treatment. Traditional braces use brackets that are much larger than the small dots used by Invisalign, which can cause mouth sores and cut the mucous membrane during the initial stage of treatment.

In addition, traditional braces tend to cause more discomfort during wire changes compared to Invisalign, which only requires replacement of aligners. As someone who has undergone traditional braces, I remember struggling to eat french fries immediately after a wire change, as I could not bite into them and had to soak them in saliva to soften them before biting.

• 了解小豆豆：隱形矯正中你可能會遇到的小裝置

飲食自由度 Dietary Freedom：

由於隱適美隱形牙套是可以拿上拿下的，所以飲食上與矯正前無太大差異，當然如果有黏上鈕扣的還是會建議避免食用太硬的食物以免鈕扣脫落。傳統矯正則是因為有金屬矯正器與矯正線在牙齒上，會建議避免「硬、黏、色素重易染色」的食物以免矯正器或是矯正線脫落與染色，另外像容易有細小魚刺的魚類也建議避免，因為有矯正器在嘴巴會稍微影響嘴巴的靈敏度，比較不易察覺細小的魚刺。

Because Invisalign aligners are removable, there are few restrictions on diet, although it is recommended to avoid hard or sticky foods when aligner buttons are attached to the teeth to prevent detachment. Traditional braces, on the other hand, require that patients avoid “hard, sticky, and heavily pigmented” foods to prevent bracket or wire detachment and staining. Additionally, fish with small bones are not recommended, as the braces can slightly affect the sensitivity of the mouth, making it more difficult to detect small bones.

口腔衛生Oral Hygiene：

一樣的道理，隱適美隱形牙套拿下後，跟矯正前的刷牙沒什麼不同。傳統矯正則是因為矯正器與矯正線的干擾，會讓刷牙變得要費心一些，需要配合「矯正用牙刷，牙間刷跟單束毛牙刷」來幫助清潔，另外矯正線和牙齒間也是容易卡菜渣的地方，所以有時候會遇到清潔習慣不佳的患者，矯正完發現很多蛀牙。隱適美隱形牙套在清潔上會比傳統矯正簡單許多，適合容易蛀牙或是有牙周病的患者。

The same logic applies to oral hygiene. Removing Invisalign aligners is similar to brushing before orthodontic treatment. Traditional braces require more attention to brushing and flossing, as the brackets and wires can create hard-to-reach areas where food debris can accumulate. As a result, some patients with poor oral hygiene habits may experience more cavities after orthodontic treatment. Invisalign aligners are much easier to clean than traditional braces and are more suitable for patients with a history of cavities or gum disease.

回診次數及間隔時間 Frequency and Interval of Follow-up Visit：

隱適美隱形牙套的治療方式是這樣：利用大數據將0到1的治療階段分配好（0 矯正前，1矯正牙齒最終位置）一次全部製作，在與你的醫師確認好治療計畫之後，醫師就會收到你治療期間的所有牙套了。這樣的好處是醫師可以一次給予你多付的隱形牙套，你可以在家裡面自己替換，每隔一段時間再回診給醫師確認牙齒有沒有跟上治療進度，所以比較繁忙的你可以一個半月或是兩個月再回診。

傳統矯正則是需要牙醫師去調整矯正線與替換掉彈性疲乏的橡皮鏈，所以需要3~4星期回診給牙醫師做檢查與處理，回診間隔會比隱適美隱形牙套來得短，回診次數較頻繁。

The treatment approach for Invisalign is as follows: Using big data to allocate the treatment stages from 0 to 1 (0: before orthodontic treatment, 1: final position of the teeth) all at once. After confirming the treatment plan with your doctor, the doctor will receive all of your aligners during the treatment period. The advantage of this approach is that the doctor can provide you with extra aligners all at once, which you can replace by yourself at home. You can then come back to the doctor for a follow-up visit every one and a half to two months to confirm that the teeth are following the treatment progress. Therefore, if you are busy, the interval between visits can be longer.

With traditional orthodontics, the dentist needs to adjust the braces and replace the elastic fatigue rubber bands, so it is necessary to visit the dentist for a checkup and treatment every 3-4 weeks. The interval between follow-up visits is shorter than that of Invisalign, so the frequency of follow-up visits is higher.

緊急狀況 Emergency Situations：

傳統矯正會有矯正器脫落或是矯正線脫離矯正器與矯正線太長刺破臉頰的狀況，通常這些狀況都必須回診所處理。傳統矯正有時也會遇到小豆豆脫落的狀況，這些狀況不必馬上回診，可以等下次回診時再次黏上即可，減少回診次數。

With traditional orthodontics, there may be situations where the braces or wires come off, or the wire is too long and pokes the cheeks. Usually, these situations need to be handled by visiting the dentist. Traditional orthodontics may also experience situations where brackets fall off, which do not require an immediate visit and can be fixed by sticking them back on at the next visit to reduce the frequency of visits.

電腦模擬 Computer simulation：

隱適美隱形牙套和傳統矯正最大的區別就在於可以先用軟體模擬出將來的位置和治療過程中牙齒的跑位，如此一來方便醫師與患者的溝通，患者也能更直觀地去了解到將來牙齒矯正完畢後的模樣，比較傳統矯正只能用類似的病例來讓患者想像更來的具體一點。

影片中是大叔的其中一位患者的治療計畫，從影片中你可以很清楚的知道你的第一組牙套是58副，你牙齒跑位的過程， 與將來的位置。有了這些資訊，你可以很直觀地跟你的醫師溝通與想像將來矯正完成後的牙齒位置。

The biggest difference between Invisalign and traditional braces is that they can use software to simulate the future position and movement of teeth during the treatment process. This makes it easier for the doctor and patient to communicate, and the patient can more intuitively understand what their teeth will look like after correction. In contrast, traditional braces can only use similar cases to help patients imagine the results.

In the video, you can clearly see one of my patients’ treatment plan, which includes the 58 pairs of aligners, the movement of the teeth, and the final position. With this information, patients can easily communicate with their doctors and imagine the final position of their teeth after correction.

隱適美隱形牙套真的這麼理想嗎？隱適美會失敗嗎？Is Invisalign really that ideal? Can Invisalign fail?

從比較表看起來，隱形矯正似乎很理想？不是，隱適美隱形牙套要配戴才有用，需要仰賴患者的自律性。

隱適美的強項在於：美觀，矯正過程較舒適，易清潔，適合忙碌不常有時間回診的患友，弱項則是：極度依靠患友的佩戴，隱形牙套放在牙套盒是沒有用的，要配戴在牙齒上20~22個小時才能有效地移動牙齒。傳統矯正則是因為矯正器及矯正線是黏在牙齒上，所以24小時都是在作用，不用擔心忘記配戴牙套的狀況發生，但是有清潔不易跟剛換線疼痛的問題。另外隱適美隱形牙套從取模、治療計畫規劃與討論到牙套製作，所需時間較長，大概需要一個半月左右的時間，所以不適合急著要開始矯正的患者。傳統矯正跟隱形矯正都是行之有年的有效矯正，大家可以根據上述的表格考量自己的需求來選擇治療方式。

Looking at the comparison chart, it seems like invisible orthodontics is very ideal. However, Invisalign only works when it is worn, relying heavily on the patient’s compliance.

The strengths of Invisalign include: aesthetics, a more comfortable correction process, easy to clean, suitable for busy patients who do not have time for frequent appointments. Its weakness lies in its extreme dependence on the patient’s wear time. Invisalign aligners are ineffective when left in the case; they need to be worn on the teeth for 20-22 hours a day to effectively move the teeth. Traditional orthodontics, on the other hand, works 24/7 because the braces and wires are adhered to the teeth, eliminating the risk of forgetting to wear them. However, traditional orthodontics has issues with cleaning and discomfort when the wires are tightened. In addition, Invisalign requires a longer lead time from the mold taking, treatment planning and discussion, to aligner production, taking about a month and a half, which is not suitable for patients who are in a rush to begin treatment. Both traditional and invisible orthodontics are effective methods of treatment, and patients can choose the best option based on their individual needs by considering the above chart.

• 你可能想了解：隱適美矯正前的評估有哪些？矯正評估費用？了解矯正前評估流程。

我適合隱適美嗎？Is Invisalign suitable for me?

以下大叔列出幾點，如果你有以下幾點需求，隱形矯正或許比傳統矯正適合你。

I has listed several points below, and if you have the following needs, Invisalign may be more suitable for you than traditional braces.

1.美觀需求 Aesthetic requirements:：

可能你是演講者，空姐，模特兒，不想在講話時露出一嘴鋼牙，或是不想讓別人知道你正在做矯正，隱形矯正在外觀上更容易達到你的需求。

Perhaps you are a speaker, flight attendant, or model who does not want to show a mouth full of metal braces while speaking, or you do not want others to know that you are undergoing orthodontic treatment. Invisalign is more likely to meet your needs in terms of appearance.

2.常出國或出差的商務人士、忙碌的學生 Business travelers who frequently travel abroad、Student who’s very busy：

比起傳統矯正必需2個禮拜回診一次，隱形矯正有更彈性的回診時間，可以2~3個月甚至6個月回診，適合時間比較不固定的人，另外搭配隱適美本身的視訊診察，更可以讓你在異地就可以獲得完整的醫療資訊。

Compared to traditional braces, which require a visit to the dentist every two weeks, Invisalign offers more flexible appointment times, allowing you to visit the dentist every 2-3 months or even 6 months. This is suitable for people with less fixed schedules. In addition, the Invisalign system includes virtual consultations, which can provide you with complete medical information even if you are in a different location.

3.害怕看牙的疼痛 Afraid of dental pain：

因為自己被做過傳統矯正，大叔永遠忘不了有一次換完線後去吃Ikea薯條，牙齒痛到只能先用口水把薯條泡軟再吃的慘況。在大叔的隱適美患者中，抱怨換完牙套牙齒痛的比例明顯比傳統矯正低很多。

Ｉ will never forget the time when he had traditional braces and after changing the wire, he went to eat Ikea french fries, and his teeth hurt so much that he had to soften the fries with saliva before he could eat them. Among Uncle’s Invisalign patients, the proportion of complaints about tooth pain after changing the aligners is significantly lower than that of traditional braces.

4.重度科技迷 Heavy technology enthusiasts：

你知道『美商隱適美公司』上市的類別是科技公司嗎？隱適美從一開始的印模是採用數位口掃的方式，矯正過程也是依靠AI跟全球1000萬名患者的大數據來做運算，連最後醫師在跟你講解治療計畫的時候也可以很高科技。電腦動畫模擬圖讓你所見即所得，可以了解自己牙齒的移動方向與最後排列位置，更方便和醫師討論達到你想要的效果，這些是傳統矯正無法做到的地方。

Do you know that Invisalign is listed as a technology company? From the beginning, Invisalign used digital impressions to make the aligners, and the treatment process relied on AI and big data from 10 million patients worldwide to calculate the optimal treatment plan. Even when the doctor explains the treatment plan to you, it can be very high-tech, with computer animation simulations allowing you to see the movement direction and final arrangement of your teeth, making it easier to discuss with the doctor and achieve the desired effect. These are areas where traditional braces cannot compete.

以上4類你是哪一類？如果你是其中一類，隱適美隱形矯正會是你的好選擇。

Which of the above four categories do you belong to? If you belong to any of them, Invisalign may be a good choice for you.