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成年患者骨性深覆合及安氏II类2分类错牙合的非手术矫治

Nonsurgical correction of skeletal deep overbite and class II division 2 malocclusion in an adult patient.

作者信息

Chen Yi-Jane, Yao Chung-Chen Jane, Chang Hsin-Fu

机构信息

Department of Orthodontics, School of Dentistry, College of Medicine, National Taiwan University, Taipei.

出版信息

Am J Orthod Dentofacial Orthop. 2004 Sep;126(3):371-8. doi: 10.1016/j.ajodo.2004.01.018.

Abstract

Treatment modalities for Class II Division 2 malocclusion include growth modification, dental compensation, and surgical-orthodontic therapy; which treatment is chosen depends on the patient's age and growth potential. Deep overbite can be corrected by intrusion of anterior teeth, extrusion of posterior teeth, or a combination of both. Treatment considerations include the patient's facial profile, skeletal pattern, growth potential, and severity of dental malocclusion. Here, we present the nonsurgical orthodontic treatment of an adult patient with deep overbite and underlying skeletal Class II discrepancy. He had a hypodivergent facial pattern, Class II Division 2 malocclusion, and traumatic deep overbite due to supereruption of the mandibular anterior teeth. He refused orthognathic surgery but would accept orthodontic treatment alone, with the understanding that the treatment results could be compromised. We corrected the deep overbite by proclining the mandibular incisors; this helped to level the exaggerated curve of Spee. The posttreatment occlusion was significantly improved, both functionally and esthetically, with stable interincisal contacts. However, the improvement in occlusion and esthetics was achieved at the expense of reduced periodontal support for the mandibular anterior teeth.

摘要

安氏II类2分类错牙合的治疗方式包括生长改良、牙齿代偿和外科正畸治疗;具体选择哪种治疗方法取决于患者的年龄和生长潜力。深覆牙合可以通过压低前牙、伸长后牙或两者结合来矫正。治疗时需要考虑患者的面部轮廓、骨骼类型、生长潜力以及牙列错牙合的严重程度。在此,我们介绍一位成年深覆牙合且伴有潜在骨骼II类错牙合畸形患者的非手术正畸治疗病例。该患者面部垂直向生长型低角,安氏II类2分类错牙合,因下颌前牙过度萌出导致创伤性深覆牙合。他拒绝接受正颌手术,但愿意接受单纯正畸治疗,并明白治疗效果可能会受到影响。我们通过唇倾下颌切牙来矫正深覆牙合;这有助于整平过大的司皮曲线。治疗后的咬合在功能和美观方面均有显著改善,切牙间接触稳定。然而,咬合和美观的改善是以牺牲下颌前牙的牙周支持为代价的。

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