因影响颜面美观, 儿童错(牙合)畸形中的上下颌牙弓/颌骨矢状向不调容易被家长发现, 临床就诊率较高.临床医生在进行诊断与矫治设计时, 也更多关注矢状向问题, 常使用头颅侧位片进行辅助诊断分析, 容易忽略横向问题.由于牙、颌、面是一个整体, 其在矢状向、垂直向、横向三维方向上互相制约与协调, 横向不调可能是发生矢状向或垂直向不调的起因.应用头颅正位片、牙(牙合)模型以及锥形束CT等对上下颌骨/牙弓间横向不调进行正确评估与诊断, 及时发现矢状向不调临床表现下隐含的横向问题并给予恰当的矫治, 有助于解决矢状向及垂直向问题, 使矫治结果更理想、更稳定.此外, 横向发育不足对微笑美学的影响也越来越受到医患的共同关注, 通过扩大牙弓进行早期矫治, 可明显改善患儿的笑容, 降低二期治疗难度, 简化疗程, 提高疗效.%The sagittal discrepancy in children which undermines esthetics to a great extent is frequently noticed by parents and is the major reason for patients to seek treatment.Transverse discrepancy, however, is more prone to be overlooked by orthodontists due to the overemphasis of diagnosis and treatment of the sagittal discrepancy. Furthermore, the discrepancies in all three dimensions of space are highly correlated and reciprocally reinforced. Therefore the transverse discrepancy should not be neglected owing to its potential of worsening the discrepancies in other dimensions. Comprehensive evaluation and accurate diagnosis of transverse discrepancy along with all other discrepancies by using postero-anterior cephalogram, plaster cast and cone-beam computerized tomography (CBCT) is positively contributed to getting esthetic and stable treatment results. Besides, a beautiful smile is always compromised by a narrow dental arch, but a full smile, which can be readily achieved by arch expansion, is always what patients are looking for and what orthodontists are working hard to get. Early treatment with maxillary expansion is able to not only improve smile esthetics of children but also lower the treatment complexity and enhance the effectiveness of the second phase orthodontic treatment.
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