暴牙可以正畸吗？先看你的「暴」是牙齿还是骨头｜證據鏈

暴牙可以正畸吗？先看你的「暴」是牙齿还是骨头｜證據鏈

F-Units（事实单元帐）

• F1｜本题选题依据＝14 诊所站 GSC 全量对帐，查询词「龅牙正畸」在之合计曝光 305（75 列、点击 0），2026-08-06 以 awk 对原始 TSV 重跑对帐，与伫列页诊所补题表数字相符；挂载栏为「」1 家。｜来源 #23｜confidence=high｜basis=internal_dataset｜period=GSC 保留窗（2025-03-22 起）｜geo: TW｜caveat：曝光为属性级数字、非去重流量；内部数据，非医学宣称，不进发布可见层。
• F2［结构性整理］｜把口语词“龅牙”拆成三层（前牙水平覆盖过大／齿槽性前突／骨性第二类）的分流框架、与费用卡、隐形正畸限制卡、地包天卡、牙齿外伤急症卡的 canonical 边界声明，以及「本卡只谈处置类别、正文不以装置比较给出选择建议」的分工决定（风险段落引述来源原文中的装置别比较不在此限，该类引述仅用于标明证据条件），皆为本站编辑定义的结构，非任何学会或文献的正式分类系统；本卡把 overjet 中译为「前牙水平覆盖」并向读者说明为「上前牙相对下前牙向前突出的水平距离」，同属编辑性的用语对应——各来源以毫米测量 overjet（见 F9、F13），但本卡引用的来源中没有一篇提供该词的逐字定义句，故不得标为文献事实。｜confidence=n/a｜basis=editorial｜geo: universal｜caveat：不得标为待验（避免制造假查证工作）；本框架不构成诊断分类，临床分类须由牙医师判定。
• F3［结构性整理］｜「胜算比是人群指标不是个人风险」「分类无法自行判定」「本站不对拔牙与否给方向」「不承诺任何外观结果」「使用消费者直送装置出现异状应停止自行调整并就诊」等阅读框架与保守取向措辞，皆为本站编辑决定，非文献导出之阈值或建议。｜confidence=n/a｜basis=editorial｜geo: universal｜caveat：同上，不得标为待验；本节不构成诊断或治疗建议。
• F4｜Cochrane 回顾背景：上前牙前突是常见状况，影响英国约四分之一的十二岁儿童；此状况于恒牙萌发时发展；这些牙齿较容易受伤，而其外观可能造成明显的困扰。｜来源 #2｜confidence=moderate｜basis=peer_reviewed（Cochrane 系统性回顾，CD003452 pub4）｜period=2018（检索至 2017-09-27；本卡 2026-08-06 于 PubMed 以「CD003452」检索，命中 2007 pub2、2013 pub3、2018 pub4 三版，pub4 为现行最新版，pubtype 未含 Retracted Publication）｜geo: universal（患病率数字限英国）｜caveat：四分之一为英国人群数字，禁外推至其他国家；「外观可能造成明显的困扰」为该回顾背景对就医动机的描述，不得被引用为任何外观改善的疗效陈述。
• F5｜头影测量研究：四十八位不同族裔的双颚前突病人，全部以拔除四颗小臼齿并后退前牙治疗；治疗前呈现前牙唇倾与前突增加、垂直向脸型型态、嘴唇前突增加、鼻唇角变小、上下颌前牙区齿槽骨薄且长。｜来源 #7｜confidence=low｜basis=peer_reviewed（回溯性头影测量研究）｜period=2005（本卡 2026-08-06 检索另见 2019、2024 年之相关系统性回顾，主题为整体后退与骨钉锚定的效果比较，未取代本篇对形态特征的描述）｜geo: universal｜caveat：样本四十八人、单一人群来源、皆为已接受拔牙治疗者；本卡仅引用其形态特征描述，不引用其治疗效果评语（原文对该治疗使用了强烈措辞，本卡不转译亦不采用）。
• F6｜系统性回顾纳入人群：骨性第二类咬合不正、下颌后缩、且已结束生长期的病人；比较掩饰性正畸与手术合并正畸的牙齿、骨骼与美观结果，结局变项包含上颌相对颅底角度、上下颌差值角度、下颌相对颅底角度等侧颅测量指标。｜来源 #9｜confidence=moderate｜basis=peer_reviewed（系统性回顾与统合分析）｜period=2018（本卡 2026-08-06 检索未见同题新版；同作者群 2022 年另有第三类的对应回顾，非本题）｜geo: universal｜caveat：本条仅陈述其纳入人群与结局指标，用以支持「骨性第二类」与「生长是否结束」的临床区分；不得读成任何治疗推荐。
• F7｜系统性回顾：检视二维侧颅测量在正畸上的效度；电子检索在三个资料库分别得到七百八十四、一千零三十四与二百六十四篇，十七篇符合纳入条件；作者结论为，尽管已有九百六十八篇同侪审查文献，这项技术在正畸上有用性的科学证据仍然不足，且结果互相矛盾。｜来源 #15｜confidence=moderate（对「证据不足」这个结论）｜basis=peer_reviewed（系统性回顾）｜period=2013（本卡 2026-08-06 检索未见同题新版系统性回顾）｜geo: universal｜caveat：「效度证据不足」不等于「不该拍」或「拍了没用」，该回顾要求的是更严谨的研究；本卡仅用它支持「分类是临床综合判断、非单一影像自动判定」，不得改写为任何检查建议或反建议。
• F8｜系统性回顾与统合分析设计：题目与计划书事前登录于约翰娜布里格斯研究所与 PROSPERO（CRD42017060907），采该所关联性（病因）系统性回顾方法；三步骤检索含四个资料库与灰色文献；仅纳入方法学品质高、偏差风险低的研究；自三千七百一十八篇文章中纳入四十一篇。｜来源 #1｜confidence=high（对设计）｜basis=peer_reviewed（系统性回顾与统合分析）｜period=2019｜geo: universal｜caveat：本条仅陈述设计；纳入研究以观察性设计为主，关联不等于因果。
• F9｜同篇结果：增加的前牙水平覆盖在所有齿列阶段与年龄层都与较高的外伤胜算显著相关；零至六岁、覆盖大于或等于三毫米者胜算比 3.37（95% 置信区间 1.36 至 8.38，P = 0.009）；混合齿列与恒齿列、覆盖大于五毫米者胜算比 2.43（95% 置信区间 1.34 至 4.42，P = 0.004）；十二岁儿童、覆盖大于五毫米者胜算比 1.81（95% 置信区间 1.44 至 2.27，P < 0.0001）。｜来源 #1｜confidence=moderate｜basis=peer_reviewed｜period=2019（本卡 2026-08-06 以「overjet + dental trauma + systematic[sb] + 2020:2026[dp]」检索，未见取代本篇之同题新版统合分析；较新者为 2020 年统合回顾 F11 与 2022 年巴西人群回顾 F12，两者方向一致但范围不同）｜geo: universal｜caveat：胜算比为人群层级关联指标，非个人风险机率，亦不代表因果；三个置信区间皆不含 1，但区间宽度差异大（0-6 岁组上下限相差近六倍），代表该层估计的精确度低。
• F10｜同篇结论：结果证实增加的前牙水平覆盖与牙外伤之间的关联；乳齿列儿童在覆盖大于或等于三毫米时可被视为具外伤风险，早期恒齿列的外伤门槛为覆盖大于或等于五毫米。｜来源 #1｜confidence=moderate｜basis=peer_reviewed｜period=2019｜geo: universal｜caveat：该篇结果段对恒齿列使用「大于五毫米」、结论段使用「大于或等于五毫米」，端点用词不一致；本卡两种写法皆照原文列出、不代为择一，临床上落在边界者须由牙医师依整体状况判断。
• F11｜统合系统性回顾的回顾：纳入十九篇系统性回顾（四篇方法学品质极低、十一篇低、四篇中等），汇整之原始研究含二百四十九篇横断面等设计；男性、儿童年龄、较大的前牙水平覆盖、嘴唇覆盖不足、前牙开咬、恒齿龋齿、过重、既往外伤史、舌环、饮酒与运动参与，皆与较高的牙外伤机会相关；作者同时指出多数纳入的系统性回顾品质偏低，可能无法提供准确而完整的证据总结。｜来源 #5｜confidence=moderate｜basis=peer_reviewed（系统性回顾之统合回顾，AMSTAR 2 评估）｜period=2020｜geo: universal｜caveat：这是「相关」的清单，不是风险排序，也不是可自我对照的评分表；作者对纳入回顾品质的保留必须与结论并陈。
• F12｜系统性回顾与统合分析：巴西零至十九岁健康儿童与青少年；自二千四百九十三笔初始结果纳入五十五篇（67% 为低偏差风险）；嘴唇覆盖不足者发生牙外伤的可能性为 1.86 至 2.36 倍，前牙水平覆盖增加者为 1.94 至 3.11 倍，乳齿列合并前牙开咬者为 1.76 倍（95% 置信区间 1.20 至 2.59）；证据确定性（GRADE）自极低到中等不等。｜来源 #4｜confidence=moderate｜basis=peer_reviewed｜period=2022｜geo: universal｜caveat：人群限定为巴西，倍数为该人群的合并估计、非个人风险；原文以「1.86 至 2.36 倍」等区间呈现不同分层的估计，本卡照列不作平均。
• F13｜文献综述：以十个主题检视严重咬合不正可能的后果；除成人严重咬合不正者的口腔健康相关生活品质较正常咬合者差、以及恒齿列覆盖大于五毫米、乳齿列三毫米时牙外伤风险增加这两项之外，其余结论所依据的证据为低到中等品质且偏差风险高。｜来源 #6｜confidence=low-moderate｜basis=peer_reviewed（叙述性文献综述，非统合分析）｜period=2022｜geo: universal｜caveat：叙述性综述，证据等级低于 F8–F12 的统合分析；本卡仅用它佐证外伤门槛的独立记载与「其他后果证据较弱」这个限制，不引用其个别主题结论。
• F14｜Cochrane 回顾设计与早晚期比较：纳入二十七项随机对照试验、一千二百五十一位受试者；三项试验比较以功能性装置做早期治疗与晚期治疗；两组都完成治疗后，最终前牙水平覆盖无差异（平均差 0.21，95% 置信区间 −0.10 至 0.51，P = 0.18，三百四十三人，低品质证据），上下颌差值角度亦无差异（平均差 −0.02，95% 置信区间 −0.47 至 0.43，三百四十七人，中等品质证据）。｜来源 #2｜confidence=high（对设计）｜basis=peer_reviewed（Cochrane 系统性回顾）｜period=2018（现行最新版，见 F4 版本链查证）｜geo: universal｜caveat：最终覆盖的置信区间跨越 0，未排除无差异，不得写成任一方较优；本条仅适用儿童与青少年人群。
• F15｜同篇：以功能性装置做早期治疗者，门牙外伤发生率低于晚期治疗（胜算比 0.56，95% 置信区间 0.33 至 0.95，三百三十二人，中等品质证据）；晚期治疗组 30%（51/171）回报新发生的门牙外伤，早期治疗组为 19%（31/161）。｜来源 #2｜confidence=moderate｜basis=peer_reviewed｜period=2018｜geo: universal｜caveat：人群为七至十一岁开始治疗的儿童，非成人；51/171 与 31/161 为原文报告之绝对数，本卡未做任何换算；此为群体发生率差异，不是个人受伤与否的预测。
• F16｜同篇：两项试验比较以头帽做早期治疗与晚期治疗；早期（两阶段）头帽治疗降低门牙外伤发生率（胜算比 0.45，95% 置信区间 0.25 至 0.80，二百三十七人，低品质证据），新发生门牙外伤者为 24/117，晚期治疗组为 44/120。｜来源 #2｜confidence=low｜basis=peer_reviewed｜period=2018｜geo: universal｜caveat：低品质证据、仅两项试验；本卡引用其方向，不引用为装置选择建议。
• F17｜同篇：七项试验比较青少年期以功能性装置治疗与不治疗；最终前牙水平覆盖减少，固定式功能性装置平均差 −5.46 毫米（95% 置信区间 −6.63 至 −4.28，二项试验六十一人）、活动式功能性装置平均差 −4.62（95% 置信区间 −5.33 至 −3.92，三项试验一百二十二人），皆为低品质证据。｜来源 #2｜confidence=low｜basis=peer_reviewed｜period=2018｜geo: universal｜caveat：人群平均的组间差异，不是任何个人可预期的减少量；对照组为不治疗，非其他治疗方式；证据品质为低。
• F18｜同篇作者结论：低到中等品质的证据显示，替上前牙前突的儿童提供早期正畸治疗，在降低门牙外伤发生率上比青少年期单一疗程更有效；相较于晚期治疗，未见提供早期治疗的其他好处；低品质证据显示相较于不治疗，青少年期以功能性装置治疗可有效降低上前牙的突出程度。｜来源 #2｜confidence=moderate｜basis=peer_reviewed｜period=2018｜geo: universal｜caveat：「更有效」限定在门牙外伤发生率这一个结局，禁扩大为整体疗效优劣；治疗时机属临床决策。
• F19｜系统性回顾与统合分析：检索一九九五年一月至二〇二五年四月，纳入十八篇研究，其中九篇提供足够覆盖资料进行统合（上下颌差值角度六篇、同侪评估分数四篇）；统合结果显示早期治疗与对照组在覆盖、上下颌差值角度与同侪评估分数上没有统计上显著的长期差异，异质性自低到中等，整体证据确定性（GRADE）为中等；作者结论为早期正畸治疗提供短期的咬合与骨骼参数改善，但现有证据不支持相对于延后介入的一致长期益处，临床决策应个别化并保留给有特定适应症者，例如功能性错咬、牙外伤风险增加或心理社会顾虑。｜来源 #3｜confidence=moderate｜basis=peer_reviewed｜period=2025｜geo: universal｜caveat：纳入设计含世代研究、非全为随机试验；「没有统计上显著的长期差异」不等于「早期治疗无用」——该篇同时记录短期改善，且其结论明列外伤风险为保留适应症之一，两件事必须并陈。
• F20｜系统性回顾与统合分析：检索至二〇一八年三月、二十四个资料库；纳入八项非随机研究（发表于十二篇论文），对象为十六岁以下、以功能性装置治疗的第二类病人，对照为未治疗者；功能性装置在几乎所有时间点改善上下颌关系（生长结束时 Wits 值平均差 −3.52 毫米，95% 置信区间 −5.11 至 −1.93，P < 0.0001）；下颌长度增加最多者为十八岁以上组（Co-Gn 平均差 3.20 毫米，95% 置信区间 1.32 至 5.08，P = 0.0009），但下颌前突程度的改善很小或未达显著；多数结局的证据品质为极低；作者结论为功能性装置「可能」在长期有效正畸骨性第二类咬合不正，然而证据品质极低且临床意义有限。｜来源 #10｜confidence=low｜basis=peer_reviewed｜period=2019｜geo: universal｜caveat：全数为非随机研究、证据品质极低；作者用的是「可能有效」，禁改写为方向性结论或疗效陈述；「下颌长度增加」与「下颌前突改善」在原文是两件事，后者被明写为很小或未达显著。
• F21｜系统性回顾与统合分析：检索至二〇一三年七月，纳入十篇文章，对象为以双板装置且非拔牙、非手术方式治疗者，须有未治疗对照组；各研究一致报告下前牙唇倾、上前牙舌倾、上颌臼齿远心移动与（或）下颌臼齿近心移动、下颌长度增加与（或）下颌前移；未发现临床上显著的上颌生长抑制；下颌骨体长度虽增加，但其颜面影响被同时增加的脸高所抵销；就嘴唇位置而言，证据不足以显示明确的变化；多数变化单独看临床意义有限，合并后才达临床重要性；无长期资料。｜来源 #11｜confidence=low｜basis=peer_reviewed｜period=2015｜geo: universal｜caveat：没有长期资料；「嘴唇位置证据不足」这一项是本卡拒绝描述外观变化的直接依据，禁被改写成任何外观方向的陈述。
• F22｜系统性回顾与统合分析：对象为十四岁以上、拔除上颌或上下颌小臼齿后进行上前牙整体后退的病人；检索一九九〇年一月至二〇一八年四月十个资料库，纳入八篇（六篇随机对照试验、两篇临床对照试验），五篇进入量化统合；整体后退造成上颌相对颅底角度与上下颌差值角度下降，各种整体后退方法之间无显著差异；作者对整体效果的评语为「弱到中等的证据」。｜来源 #8｜confidence=low｜basis=peer_reviewed｜period=2019｜geo: universal｜caveat：本卡仅引用其处置机制、方法间无显著差异，以及作者结论句的证据等级；一律不引用其对加速术式、骨钉锚定与疗程时间的组间比较（属临床端选择）。作者结论句中「改善颜面侧面」为该研究之原文用语，本卡以引述方式保留并明确标示不转译为本站判断，禁被抽出当作外观改善的疗效陈述。
• F23｜系统性回顾与统合分析：九个资料库检索至二〇一六年十二月，纳入含小臼齿拔除或不拔牙治疗的对照临床研究；拔牙治疗与下唇后退增加（二十四项研究、一千四百五十六位病人，平均差 1.96 毫米）、上唇后退增加（二十一项研究、一千一百四十九位病人，平均差 1.26 毫米）、鼻唇角增加（二十一项研究、一千零八十九位病人，平均差 4.21 度）、软组织侧面凸度（六项研究、四百零八位病人，平均差 1.24 度）与侧面「讨喜程度」（三项研究、二百四十九位病人，标准化平均差 0.41）有关；所有结果的证据品质皆为极低；作者结论为尽管拔牙看来会影响病人侧面，现有研究异质性高，无法对侧面反应做出一致的预测。｜来源 #12｜confidence=low｜basis=peer_reviewed｜period=2018（本卡 2026-08-06 检索另见 2021 年同题统合分析 F25，样本与纳入研究数皆较小，两篇结论分别记录、未合并陈述）｜geo: universal｜caveat：人群平均差，不是个人可预期的变化量；证据品质极低；「无法一致预测」是本卡不对拔牙与外观给方向的直接依据，禁被改写成任何方向性结论。
• F24｜系统性回顾：检视第二类第一分类病人以小臼齿拔除治疗后的颜面软组织头影测量变化；多数文章对治疗前咬合不正严重度的描述不一致；具统计显著的变化包含鼻唇角增加（拔两颗方案 2.4 至 5.40 度、拔四颗方案 1 至 6.84 度）与上下唇后退，其中拔两颗上颌小臼齿方案的下唇后退较少。｜来源 #13｜confidence=low｜basis=peer_reviewed（系统性回顾，未做统合分析）｜period=2016｜geo: universal｜caveat：未做统合分析、纳入研究异质性高（作者自陈严重度描述不一致）；角度区间为不同研究的范围，非合并估计值，禁被读成可预期的个人变化。
• F25｜系统性回顾与统合分析：检索 PubMed 与 SCOPUS 至二〇二〇年十一月；四项对照试验的合并资料显示拔牙与不拔牙在上颌相对颅底角度、下颌相对颅底角度、下颌平面角、下前牙倾斜角、覆盖与覆咬上无显著差异；拔牙组的上下颌差值角度显著较高（平均差 0.78，95% 置信区间 0.25 至 1.31，P = 0.004）；作者结论使用「不拔牙方案是拔牙方案安全而有效的替代选项」之措辞，并主张应采个别化治疗策略、需要更多随机对照试验。｜来源 #14｜confidence=low｜basis=peer_reviewed｜period=2021｜geo: universal｜caveat：「安全而有效的替代选项」为该篇作者用语，本卡保留为原文用语，不转译为本站的安全性或优劣判断；仅四项对照试验、仅检索两个资料库；该摘要中下前牙倾斜角的置信区间呈现内部矛盾（下限大于上限），本卡因此不引用该项数值本身。
• F26｜同 F6 之系统性回顾结果：九篇进入质性合成、七篇进入统合分析；两种治疗在上颌相对颅底角度、下唇到审美平面的线性测量、骨骼侧面凸度、不含鼻部的软组织侧面上差异未达统计显著；手术合并正畸在上下颌差值角度、下颌相对颅底角度、下颌平面角与含鼻部的软组织侧面上较为有效；覆盖与覆咬的治疗效果差异随初始值严重度而不同；作者要求谨慎解读，因纳入研究数量有限且皆为非随机临床试验。｜来源 #9｜confidence=low｜basis=peer_reviewed｜period=2018｜geo: universal｜caveat：皆为非随机试验、研究数少；「较为有效」限定在所列的测量指标上，不得被读成对个别病人的结果承诺或术式推荐。
• F27｜系统性回顾与统合分析：检索 PubMed 与 Embase（一九九八年至二〇二五年二月），纳入四十七项研究、五千四百零六位病人；「持续性感觉神经异常」定义为术后十二个月时仍被回报或评估到的感觉神经异常；矢状劈开骨切开术后一年持续性感觉神经异常的合并发生率为 21%（95% 置信区间 13% 至 32%）；较年长（九项研究中五项显著）、下颌前移量较大（两项中两项显著）、术中神经暴露或操作（三项中两项显著）与较高风险显著相关；性别、骨骼分类、固定方式、第三大臼齿存在与同时施行颏成形术则未见显著关联。｜来源 #16｜confidence=moderate｜basis=peer_reviewed｜period=2026（本卡 2026-08-06 检索之现行最新版；较早者为 2015 年之发生率系统性回顾，样本与方法学广度较小）｜geo: universal｜caveat：合并发生率为人群层级估计、非个人风险；纳入设计含回溯性世代，感觉神经异常的评估方法在各研究间未标准化（作者自陈）。
• F28｜系统性回顾与统合分析：纳入五十七项研究、九千一百零一位病人（平均年龄 16.4 岁、33.5% 为男性）；正畸病人白斑病灶的合并患病率 55.06%（95% 置信区间 47.7% 至 63.6%，四十二项研究）、发生率 34.2%（95% 置信区间 27.6% 至 40.6%，四十四项研究）、牙面层级患病率 26.9%；未治疗者的合并患病率为 29.1%（95% 置信区间 17.2% 至 41.1%，二十一项研究）；传统固定装置出现白斑病灶的胜算为其他装置的 4.7 倍（95% 置信区间 1 至 19.2，P = 0.05）、为未治疗者的七倍（95% 置信区间 2.6 至 18.5，P = 0.001）；患病率随疗程时间拉长而上升，并随族裔与侦测方法而异；作者指出三分之一的未治疗个案本身即已有白斑病灶，故治疗开始时的完整记录十分重要。｜来源 #18｜confidence=moderate｜basis=peer_reviewed｜period=2025｜geo: universal｜caveat：与其他装置比较的胜算比置信区间下限为 1、P = 0.05，属边界值，本卡正文因此仅引用「相对于未治疗」的比较；患病率随侦测方法而异，跨研究可比性有限。
• F29｜系统性回顾与统合分析：正畸引起的发炎性牙根吸收被描述为正畸治疗常见的不良作用；以锥状射束电脑断层为基础，纳入五项研究、三百三十四位受试者，资料足以分析者为上颌前牙；透明正畸装置与固定装置之间的差异未达统计显著（P > 0.05），且两组皆未呈现临床上有意义的程度（小于一毫米）；存在中度到高度的偏差风险；作者指出在非高风险人群中，不应为了担心牙根吸收而优先选择透明正畸装置。｜来源 #19｜confidence=low｜basis=peer_reviewed｜period=2025｜geo: universal｜caveat：人群为完整恒齿列且排除既往牙根吸收、外伤与根管治疗者，结果不可外推至高风险个案；「未达统计显著」不等于两者相同；本卡不引用其作为任何装置的选择建议。
• F30｜Cochrane 系统性回顾：检索至二〇二二年四月二十七日；纳入四十七项研究、四千三百七十七位受试者，比较活动式与固定式维持器、不同固定式维持器或黏著材料、不同活动式维持器；二十八项研究判定为高偏差风险；以十二个月追踪为焦点，证据为低或极低确定性；作者结论为无法就任何一种维持方式优于另一种下确定结论，并指出多数研究的追踪期不到一年，需要更多测量至少两年稳定度的高品质研究。｜来源 #17｜confidence=high（对「证据不足以比较」这个结论）｜basis=peer_reviewed（Cochrane 系统性回顾，CD002283 pub5，2016 pub4 之更新版）｜period=2023（本卡 2026-08-06 检索确认为现行最新版，pubtype 未含 Retracted Publication）｜geo: universal｜caveat：该回顾排除使用透明正畸装置的研究；「无法比较优劣」不等于「不需要维持」——原文背景明写没有维持阶段，牙齿倾向复发，两者禁混写。
• F31｜横断面评估研究：评估二十一个消费者直送正畸装置供应商网站的治疗资讯品质；提及治疗前口腔健康需求者 38.1%、提及疗程后需无限期维持者 23.8%；95.2% 的网站依 DISCERN 分数被归类为差或很差，其中资讯偏误与治疗风险两项得分特别低；可读性评分显示内容难以阅读；作者结论为仅依网站资讯作出的治疗同意很可能无效。｜来源 #21｜confidence=moderate｜basis=peer_reviewed（网站内容评估研究）｜period=2021｜geo: universal｜caveat：评估对象为网站内容，不是治疗结果；「同意很可能无效」是该研究对资讯揭露的评语，本卡不作任何法律见解之引申。
• F32｜使用者调查：二十四题线上问卷，于社群平台与相关论坛招募（二〇一九年三月至八月），分析四百七十份回应；典型受访者为白人千禧世代女性、因拥挤而购买；超过半数在购买前曾咨询牙医师，且该牙医师多半建议院内治疗；87.5% 对治疗感到满意，6.6% 因不良反应之严重程度而必须就医。｜来源 #20｜confidence=low｜basis=peer_reviewed（自选样本横断面调查）｜period=2020｜geo: universal｜caveat：社群平台招募的自选样本、非机率抽样，两个百分比皆不可读为一般人群的满意率或并发症发生率；本卡不引用其对业界共存模式的政策性建议。
• F33｜横断面调查：于西班牙进行、为期一年的线上问卷，分析一百零一份有效回应；多数受访者表示期待未被满足、不会推荐此类服务；选择动机以费用为首、便利性次之；许多使用者出现并发症并因此就诊；各供应商间整体满意度无显著差异，但在不适程度、可及的面对面照护与额外咨询需求上有差异。｜来源 #22｜confidence=low｜basis=peer_reviewed（单一国家横断面调查）｜period=2025｜geo: universal｜caveat：样本一百零一人、单一国家、自填问卷；「许多使用者」为原文之非量化描述，本卡未替它换算任何比例。
• F34｜台湾《医疗法》第 81 条：医疗机构诊治病人时，应向病人或其法定代理人、配偶、亲属或关系人告知其病情、治疗方针、处置、用药、预后情形及可能之不良反应。｜来源 #24｜confidence=high｜basis=law｜period=现行条文（2026-08-06 以 ego-browser 实载全国法规资料库页面，标题「醫療法§81-全國法規資料庫」，条文逐字取得并核对；同 VERIFIED-FACTS 已验锚）｜geo: TW｜caveat：条文转述，非法律意见；本卡据此把治疗计划与风险说明导回诊间。
• F35｜台湾《医疗法》第 87 条：广告内容暗示或影射医疗业务者，视为医疗广告；医学新知或研究报告之发表、病人卫生教育、学术性刊物，未涉及招徕医疗业务者，不视为医疗广告。｜来源 #24｜confidence=high｜basis=law｜period=现行条文（2026-08-06 以 ego-browser 实载，标题「醫療法§87-全國法規資料庫」，两项条文逐字取得；同 VERIFIED-FACTS 已验锚）｜geo: TW｜caveat：本卡定位依据；在其他国家发布时，卫教与广告的界线请以当地法规为准。

来源清单

1. Arraj GP, Rossi-Fedele G, Doğramacı EJ. The association of overjet size and traumatic dental injuries-A systematic review and meta-analysis. Dent Traumatol. 2019 Oct;35(4-5):217-232. PMID 31062510. https://pubmed.ncbi.nlm.nih.gov/31062510/（取用 2026-08-06，efetch 摘要取回成功）。逐字 span：「The title and protocol were registered and published a priori with the Joanna Briggs Institute (JBI) and PROSPERO (CRD42017060907)」「Only high methodological quality studies with low risk of bias were included」「The study identified 3718 articles, 41 were included. An increased overjet was significantly associated with higher odds of developing trauma in all dentition stages and age groups. Children 0-6 years with an overjet ≥3mm have an odds of 3.37 (95%CI, 1.36-8.38, P = 0.009) for trauma. Children in the mixed and secondary dentition with an overjet >5mm have an odds of 2.43 (95%CI, 1.34-4.42, P = 0.004). Twelve-year-old children with an overjet >5mm have an odds of 1.81 (95%CI, 1.44-2.27, P < 0.0001)」「A child in the primary dentition could be considered as having an overjet at risk for trauma when it is ≥3mm. In the early secondary dentition, the threshold for trauma is an overjet ≥5mm」
2. Batista KB, Thiruvenkatachari B, Harrison JE, O'Brien KD. Orthodontic treatment for prominent upper front teeth (Class II malocclusion) in children and adolescents. Cochrane Database Syst Rev. 2018 Mar 13;3(3):CD003452. PMID 29534303. https://pubmed.ncbi.nlm.nih.gov/29534303/（取用 2026-08-06，efetch 摘要取回成功；版本链以「CD003452」检索确认 pub4 为现行最新版）。逐字 span：「Prominent upper front teeth are a common problem affecting about a quarter of 12-year-old children in the UK. The condition develops when permanent teeth erupt. These teeth are more likely to be injured and their appearance can cause significant distress」「We included 27 RCTs based on data from 1251 participants」「when both groups had completed treatment, there was no difference between groups in final overjet (MD 0.21, 95% CI -0.10 to 0.51, P = 0.18; 343 participants) (low-quality evidence) or ANB (MD -0.02, 95% CI -0.47 to 0.43; 347 participants) (moderate-quality evidence)」「Early treatment with functional appliances reduced the incidence of incisal trauma compared to late treatment (OR 0.56, 95% CI 0.33 to 0.95; 332 participants) (moderate-quality evidence). The difference in the incidence of incisal trauma was clinically important with 30% (51/171) of participants reporting new trauma in the late treatment group compared to only 19% (31/161) of participants who had received early treatment」「Early (two-phase) treatment with headgear reduced the incidence of incisal trauma (OR 0.45, 95% CI 0.25 to 0.80; 237 participants) (low-quality evidence), with almost half the incidence of new incisal trauma (24/117) compared to the late treatment group (44/120)」「There was a reduction in final overjet with both fixed functional appliances (MD -5.46 mm, 95% CI -6.63 to -4.28; 2 trials, 61 participants) and removable functional appliances (MD -4.62, 95% CI -5.33 to -3.92; 3 trials, 122 participants) (low-quality evidence)」「Evidence of low to moderate quality suggests that providing early orthodontic treatment for children with prominent upper front teeth is more effective for reducing the incidence of incisal trauma than providing one course of orthodontic treatment in adolescence. There appear to be no other advantages of providing early treatment when compared to late treatment. Low-quality evidence suggests that, compared to no treatment, late treatment in adolescence with functional appliances, is effective for reducing the prominence of upper front teeth」
3. Almugla YM, Shekhar MG. Does Early Orthodontic Treatment in Mixed Dentition Improve Long-Term Outcomes? A Systematic Review and Meta-Analysis. Medicina (Kaunas). 2025 Oct 16;61(10):1854. PMID 41155841. https://pubmed.ncbi.nlm.nih.gov/41155841/（取用 2026-08-06，efetch 摘要取回成功）。逐字 span：「A total of 18 studies were included in the systematic review, of which nine provided sufficient data on overjet for meta-analysis, with overlapping datasets available for ANB angle (n = 6) and PAR scores (n = 4). Meta-analyses showed no statistically significant long-term differences between early treatment and control groups in overjet, ANB angle, or PAR scores. Heterogeneity across outcomes ranged from low to moderate. The overall certainty of the evidence was rated as moderate」「Early orthodontic treatment provides short-term improvements in occlusal and skeletal parameters. However, current evidence does not support consistent long-term benefits over delayed intervention. Clinical decision-making should be individualized and reserved for cases with specific indications, such as functional crossbites, increased risk of dental trauma, or psychosocial concerns」
4. Vieira WA, Pecorari VGA, Gabriel PH, et al. The association of inadequate lip coverage and malocclusion with dental trauma in Brazilian children and adolescents - A systematic review and meta-analysis. Dent Traumatol. 2022 Feb;38(1):4-19. PMID 34275184. https://pubmed.ncbi.nlm.nih.gov/34275184/（取用 2026-08-06，efetch 摘要取回成功）。逐字 span：「The search presented 2493 initial results, from which 55 met the eligibility criteria and were included. Most studies (67%) presented a low risk of bias」「Children and adolescents with inadequate lip coverage are 1.86-2.36 times more likely to suffer from DT, while those with increased overjet are 1.94-3.11 times more likely. Children with primary dentitions and anterior open bites are 1.76 (95% CI: 1.20-2.59) times more likely to suffer from DT. The certainty of evidence varied from very low to moderate」
5. Magno MB, Nadelman P, Leite KLF, Ferreira DM, Pithon MM, Maia LC. Associations and risk factors for dental trauma: A systematic review of systematic reviews. Community Dent Oral Epidemiol. 2020 Dec;48(6):447-463. PMID 32893395. https://pubmed.ncbi.nlm.nih.gov/32893395/（取用 2026-08-06，efetch 摘要取回成功）。逐字 span：「19 systematic reviews were included in this overview. Four were classified with critically low, eleven with low and four with moderate methodological quality」「Male gender, child age, greater overjet, inadequate lip coverage, anterior open bite, caries in the permanent dentition, overweight, a previous history of TDI, tongue piercing, the use of alcoholic beverages and participation in sports were all associated with a greater chance of suffering TDI」「most of the systematic reviews included were of a low quality and may not provide an accurate and comprehensive summary of the available research that addresses the question of interest」
6. Leck R, Paul N, Rolland S, Birnie D. The consequences of living with a severe malocclusion: A review of the literature. J Orthod. 2022 Jun;49(2):228-239. PMID 34488471. https://pubmed.ncbi.nlm.nih.gov/34488471/（取用 2026-08-06，efetch 摘要取回成功）。逐字 span：「With the exception of Oral Health Related Quality Of Life, which is poorer in adults with severe malocclusion than those with normal occlusions, and the risk of Traumatic Dental Injury, which increases when the overjet is >5 mm in the permanent and 3 mm in the primary dentition, the evidence supporting the remaining conclusions was found to be of low to moderate quality and at high risk of bias」
7. Bills DA, Handelman CS, BeGole EA. Bimaxillary dentoalveolar protrusion: traits and orthodontic correction. Angle Orthod. 2005 May;75(3):333-9. PMID 15898369. https://pubmed.ncbi.nlm.nih.gov/15898369/（取用 2026-08-06，efetch 摘要取回成功）。逐字 span：「A group of 48 ethnically diverse patients with bimaxillary protrusion was used to study the pretreatment cephalometric traits of this malocclusion and the effect of orthodontic correction. All patients were treated with four premolar extractions and retraction of the anterior teeth」「Patients with bimaxillary protrusion demonstrated increased incisor proclination and protrusion, a vertical facial pattern, increased procumbency of the lips, a decreased nasolabial angle, and thin and elongated upper and lower anterior alveoli」
8. Khlef HN, Hajeer MY, Ajaj MA, Heshmeh O. En-masse Retraction of Upper Anterior Teeth in Adult Patients with Maxillary or Bimaxillary Dentoalveolar Protrusion: A Systematic Review and Meta-analysis. J Contemp Dent Pract. 2019 Jan 1;20(1):113-127. PMID 31058623. https://pubmed.ncbi.nlm.nih.gov/31058623/（取用 2026-08-06，efetch 摘要取回成功）。逐字 span：「The participants were patients over 14 years old undergoing fixed orthodontic treatment with extraction of maxillary or bimaxillary premolars followed by en-masse retraction of maxillary anterior teeth in both groups」「Eight articles (six RCTs and two CCTs) were included in this review, and only five articles were suitable for quantitative synthesis. The en-masse retraction caused a decrease in the SNA and ANB angles with no significant differences between the different en-masse retraction methods」「There is a weak to moderate evidence that using accelerated and non-accelerated methods would improve the facial profile and lead to similar skeletal corrections」
9. Raposo R, Peleteiro B, Paço M, Pinho T. Orthodontic camouflage versus orthodontic-orthognathic surgical treatment in class II malocclusion: a systematic review and meta-analysis. Int J Oral Maxillofac Surg. 2018 Apr;47(4):445-455. PMID 28966066. https://pubmed.ncbi.nlm.nih.gov/28966066/（取用 2026-08-06，efetch 摘要取回成功）。逐字 span：「This systematic review was performed to compare dental, skeletal, and aesthetic outcomes between orthodontic camouflage and surgical-orthodontic treatment, in patients with a skeletal class II malocclusion and a retrognathic mandible who have already finished their growth period」「Nine articles were included in the qualitative synthesis and seven in the meta-analysis. The difference between treatments was not statistically significant regarding SNA angle, linear measurement of the lower lip to Ricketts' aesthetic line, convexity of the skeletal profile, or the soft tissue profile excluding the nose. In contrast, surgical-orthodontic treatment was more effective with regard to ANB, SNB, and ML/NSL angles and the soft tissue profile including the nose. Different treatment effects on overjet and overbite were found according to the severity of the initial values. These results should be interpreted with caution, due to the limited number of studies included and because they were non-randomized clinical trials」
10. Cacciatore G, Ugolini A, Sforza C, Gbinigie O, Plüddemann A. Long-term effects of functional appliances in treated versus untreated patients with Class II malocclusion: A systematic review and meta-analysis. PLoS One. 2019 Sep 6;14(9):e0221624. PMID 31490945. https://pubmed.ncbi.nlm.nih.gov/31490945/（取用 2026-08-06，efetch 摘要取回成功）。逐字 span：「Eight non-randomised studies published in 12 papers were included. Functional appliances produced a significant improvement of the maxillo-mandibular relationship, at almost all time points (Wits appraisal at the end of growth, MD -3.52 mm, 95% CI -5.11 to -1.93, P < 0.0001). The greatest increase in mandibular length was recorded in patients aged 18 years and above (Co-Gn, MD 3.20 mm, 95% CI 1.32 to 5.08, P = 0.0009), although the improvement of the mandibular projection was negligible or not significant. The quality of evidence was 'very low' for most of the outcomes at both primary time points」「Functional appliances may be effective in correcting skeletal Class II malocclusion in the long-term, however the quality of the evidence was very low and the clinical significance was limited」
11. Ehsani S, Nebbe B, Normando D, Lagravere MO, Flores-Mir C. Short-term treatment effects produced by the Twin-block appliance: a systematic review and meta-analysis. Eur J Orthod. 2015 Apr;37(2):170-6. PMID 25052373. https://pubmed.ncbi.nlm.nih.gov/25052373/（取用 2026-08-06，efetch 摘要取回成功）。逐字 span：「Proclination of lower incisors, retroclination of upper incisors, distal movement of upper molars and/or mesial movement of lower molars, increase in mandibular length, and/or forward movement of the mandible were consistently reported. Clinically significant restraint of maxillary growth was not found. Although the mandibular body length is increased, the facial impact of it is reduced by the simultaneous increment of the face height」「As for lip position, there is not enough evidence to suggest clear lip position changes」「Most of the changes individually were of limited clinical significance, but when combined reached clinical importance. No long-term changes were available」
12. Konstantonis D, Vasileiou D, Papageorgiou SN, Eliades T. Soft tissue changes following extraction vs. nonextraction orthodontic fixed appliance treatment: a systematic review and meta-analysis. Eur J Oral Sci. 2018 Jun;126(3):167-179. PMID 29480521. https://pubmed.ncbi.nlm.nih.gov/29480521/（取用 2026-08-06，efetch 摘要取回成功）。逐字 span：「Extraction treatment was associated with increased lower lip retraction (24 studies; 1,456 patients; MD = 1.96 mm), upper lip retraction (21 studies; 1,149 patients; MD = 1.26 mm), nasolabial angle (21 studies; 1,089 patients; MD = 4.21°), soft-tissue profile convexity (six studies; 408 patients; MD = 1.24°), and profile pleasantness (three studies; 249 patients; SMD = 0.41)」「the quality of evidence was very low in all cases due to risk of bias, baseline confounding, inconsistency, and imprecision. Although tooth extractions seem to affect patient profile, existing studies are heterogenous and no consistent predictions of profile response can be made」
13. Janson G, Mendes LM, Junqueira CH, Garib DG. Soft-tissue changes in Class II malocclusion patients treated with extractions: a systematic review. Eur J Orthod. 2016 Dec;38(6):631-637. PMID 26620831. https://pubmed.ncbi.nlm.nih.gov/26620831/（取用 2026-08-06，efetch 摘要取回成功）。逐字 span：「Heterogeneous information about malocclusion severity before treatment was found in most articles. Statistically significant soft-tissue changes reported included nasolabial angle (NLA) increasing from 2.4 to 5.40degrees in 2-premolar extraction protocol and from 1 to 6.84degrees in 4-premolar extraction protocol. Retrusion of the upper and lower lips were also verified, with less retraction of the lower lip in 2-premolar extraction groups」
14. Moon S, Mohamed AMA, He Y, Dong W, Yaosen C, Yang Y. Extraction vs. Nonextraction on Soft-Tissue Profile Change in Patients with Malocclusion: A Systematic Review and Meta-Analysis. Biomed Res Int. 2021 Sep 18;2021:7751516. PMID 34589550. https://pubmed.ncbi.nlm.nih.gov/34589550/（取用 2026-08-06，efetch 摘要取回成功）。逐字 span：「Pooled data from four controlled trials demonstrated a nonsignificant difference between extraction and nonextraction in terms of SNA (MD = 0.50, 95% CI: -0.37, 1.38; p = 0.26), SNB (MD = 0.11, 95% CI: -1.23, 1.44; p = 0.88)」「the extraction method significantly increased the ANB compared with the nonextraction group (MD = 0.78, 95% CI: 0.25, 1.31; p = 0.004)」「The current evidence demonstrated that nonextraction protocols for orthodontic treatment are a safe and effective alternative to extraction protocols; individually tailored treatment strategies should be applied」
15. Durão AR, Pittayapat P, Rockenbach MI, Olszewski R, Ng S, Ferreira AP, Jacobs R. Validity of 2D lateral cephalometry in orthodontics: a systematic review. Prog Orthod. 2013 Sep 20;14(1):31. PMID 24325757. https://pubmed.ncbi.nlm.nih.gov/24325757/（取用 2026-08-06，efetch 摘要取回成功）。逐字 span：「The initial search revealed 784 articles listed in MEDLINE (Ovid), 1,034 in Scopus and 264 articles in the Web of Science. Only 17 articles met the inclusion criteria and were selected for qualitative synthesis」「It is surprising that, notwithstanding the 968 articles published in peer-reviewed journals, scientific evidence on the usefulness of this radiographic technique in orthodontics is still lacking, with contradictory results」
16. Bertagna AE, Van der Cruyssen F, Miloro M. Persistent Neurosensory Disturbance Following Sagittal Split Osteotomy: A Systematic Review and Meta-Analysis of One-Year Outcomes and Risk Factors. J Oral Maxillofac Surg. 2026 Jan;84(1):25-44. PMID 40983111. https://pubmed.ncbi.nlm.nih.gov/40983111/（取用 2026-08-06，efetch 摘要取回成功）。逐字 span：「"Persistent NSD" was defined as any NSD reported or assessed at 12 months postoperatively」「The final sample comprised 47 studies (5,406 patients). The pooled 1-year incidence of persistent NSD was 21% (95% CI, 13%-32%). Older age (statistically significant in 5 out of 9 studies), greater mandibular advancement (significant in 2 out of 2 studies), and intraoperative nerve exposure/manipulation (significant in 2 out of 3 studies) were statistically significantly associated with a higher risk of persistent NSD」「persistent NSD was not significantly associated with sex (8/9 studies), skeletal class (4/5), fixation method (1/2), third molar presence (1/1), or concomitant genioplasty (3/5)」
17. Martin C, Littlewood SJ, Millett DT, Doubleday B, Bearn D, Worthington HV, Limones A. Retention procedures for stabilising tooth position after treatment with orthodontic braces. Cochrane Database Syst Rev. 2023 May 22;5(5):CD002283. PMID 37219527. https://pubmed.ncbi.nlm.nih.gov/37219527/（取用 2026-08-06，efetch 摘要取回成功）。逐字 span：「Without a phase of retention after successful orthodontic treatment, teeth tend to 'relapse', that is, to return to their initial position」「We excluded studies with aligners」「We included 47 studies, with 4377 participants」「We judged 28 studies to have high risk of bias」「The evidence is low to very low certainty, so we cannot draw firm conclusions about any one approach to retention over another. More high-quality studies are needed that measure tooth stability over at least two years」
18. Hussain U, Wahab A, Kamran MA, et al. Prevalence, Incidence and Risk Factors of White Spot Lesions Associated With Orthodontic Treatment - A Systematic Review and Meta-Analysis. Orthod Craniofac Res. 2025 Apr;28(2):379-399. PMID 39717964. https://pubmed.ncbi.nlm.nih.gov/39717964/（取用 2026-08-06，efetch 摘要取回成功）。逐字 span：「Fifty-seven studies involving 9101 patients (mean age of 16.4 years, 33.5% male) were included. Among orthodontic patients, the pooled prevalence of WSLs was 55.06% (95% CI: 47.7%, 63.6%: 42 studies), incidence was 34.2% (95% CI: 27.6%, 40.6%: 44 studies) and surface prevalence was 26.9% (6 studies; 95% CI: 13.8%, 39.8%). Among non-treated patients, the pooled prevalence of WSLs was 29.1% (95% CI: 17.2%, 41.1%; 21 studies). The odds of WSLs were significantly higher, with CFA being 4.73 times greater compared to other appliances (OR = 4.7, 95% CI: 1, 19.2, p = 0.05) and seven times higher compared to no treatment (OR = 7, 95% CI: 2.6, 18.5, p = 0.001). Prevalence of WSLs increased with longer treatment duration (p < 0.001)」「Since one-third of untreated cases already have WSLs, proper documentation at treatment start is essential」
19. Kreuter P, Sára Haba K, Kiss-Dala S, et al. Root resorption caused by aligners, self-ligating appliances, and conventional fixed appliances: a CBCT-based meta-analysis. BMC Oral Health. 2025 Jul 26;25(1):1259. PMID 40713565. https://pubmed.ncbi.nlm.nih.gov/40713565/（取用 2026-08-06，efetch 摘要取回成功）。逐字 span：「Orthodontically induced inflammatory root resorption (OIIRR) is a common adverse effect of orthodontic treatments」「The meta-analysis included five studies with 334 participants. Data on upper incisors were sufficient for analysis. Differences in OIIRR between aligners and fixed appliances did not reach statistical significance (p > 0.05), and neither group presented clinically relevant OIIRR (< 1 mm). A moderate to high risk of bias was present」
20. Wexler A, Nagappan A, Beswerchij A, Choi R. Direct-to-consumer orthodontics: surveying the user experience. J Am Dent Assoc. 2020 Aug;151(8):625-636.e4. PMID 32718492. https://pubmed.ncbi.nlm.nih.gov/32718492/（取用 2026-08-06，efetch 摘要取回成功）。逐字 span：「The authors recruited users for 6 months (March-August 2019) on social media platforms (Instagram, Twitter) and online forums related to DTC orthodontics. A total of 470 responses were analyzed」「Although most respondents (87.5%) were satisfied with DTC treatment, 6.6% had to visit their dentist due to the severity of adverse effects」
21. Meade MJ, Dreyer CW. An assessment of the treatment information contained within the websites of direct-to-consumer orthodontic aligner providers. Aust Dent J. 2021 Mar;66(1):77-84. PMID 33237579. https://pubmed.ncbi.nlm.nih.gov/33237579/（取用 2026-08-06，efetch 摘要取回成功）。逐字 span：「Twenty-one websites were evaluated. Few websites referred to the need for pre-treatment dental health (38.1%) and indefinite post-treatment retention (23.8%). Most websites (95.2%) were categorized as either 'poor' or 'very poor' according to their DISCERN scores. DISCERN items regarding information bias and treatment risks scored particularly poorly」「The quality of information contained within the websites of DTC orthodontic aligner providers is poor. Patient consent for DTC aligner treatment based solely on the information contained within the websites is likely to be invalid」
22. Adobes Martin M, Pérez Márquez A, Meuli S, et al. User Experience, Satisfaction, and Complications of Direct-to-Consumer Orthodontics in Spain: A Cross-Sectional Study. J Clin Med. 2025 Mar 30;14(7):2382. PMID 40217832. https://pubmed.ncbi.nlm.nih.gov/40217832/（取用 2026-08-06，efetch 摘要取回成功）。逐字 span：「A cross-sectional online survey was conducted over one year」「A total of 101 valid responses were analyzed using statistical means」「The majority of respondents reported that their expectations were not met, and they would not recommend DTCO. Cost was the primary motivation for treatment selection, followed by convenience. Many users experienced complications, leading to dental consultations」
23. km 牙医线选题底帐 [F1]：`km-production-queue.html` 第三区「诊所补题」表「龅牙正畸」列（曝光 305、挂载），数字以 `gsc-full-20260804/__web__full.tsv` 于 2026-08-06 重跑对帐确认（75 列、impressions 305、clicks 0）。资料源＝14 诊所资产 GSC 全量对帐。
24. 台湾《医疗法》第 81、87 条，全国法规资料库。https://law.moj.gov.tw/LawClass/LawSingle.aspx?pcode=L0020021&flno=81／https://law.moj.gov.tw/LawClass/LawSingle.aspx?pcode=L0020021&flno=87（2026-08-06 以 ego-browser 实载，页面标题分别为「醫療法§81-全國法規資料庫」「醫療法§87-全國法規資料庫」，条文逐字核对；同 VERIFIED-FACTS 已验锚）

内部引用链

• 费用正典卡：「牙套」要多少钱？先分清楚你问的是正畸牙套还是假牙牙冠（KM-DENTAL-08，草稿）与隐形正畸要花多少钱？这笔钱是怎么算出来的（KM-DENTAL-C03，草稿）。canonical 边界：正畸的收费结构、报价单读法、健保给付与否等制度面问题，一律以该两卡为准；本卡正文不列任何金额、不谈收费项目。
• 装置面卡：隐形正畸的适应范围与限制（KM-DENTAL-C07，同批制作中，连结上线后补）。透明正畸装置能完成哪些位移、什么情况需要搭配其他方式，以该卡为准；本卡只做「处置方向有哪几类」的分流，不比较装置与品牌。
• 相反方向的骨骼关系：下颌前突（俗称地包天）（KM-DENTAL-C14，同批制作中，连结上线后补）。第三类的骨骼关系与处置逻辑在该卡；本卡只做一句对照。
• 儿童装置题：上颌扩张器是什么、什么情况需要（KM-DENTAL-C18，同批制作中，连结上线后补）。生长期儿童的另一类装置在该卡；本卡的「生长改良」一节只谈策略类别，不展开任何单一装置。
• 急症卡：牙齿突然掉了一颗怎么办？（KM-DENTAL-30，草稿）。本卡谈的是外伤「风险」，该卡谈的是外伤「已经发生」之后的处置时效与红旗，两者不重叠。

发布闸门提醒：本卡为 draft。四语（zh-Hans／en／ja）未产前不得进 km_entries；本卡不含症状分级与红旗判准，但含外伤风险数字与手术并发症率，建议依审核链规格由 OP 判定是否加做第三意见。