Takano-Yamamoto Teruko, Kuroda Shingo
Department of Orthodontics and Dentofacial Orthopedics, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan.
Am J Orthod Dentofacial Orthop. 2007 Aug;132(2):237-42. doi: 10.1016/j.ajodo.2005.12.032.
Facial asymmetry is a major complaint of orthodontic patients. In those with severe facial asymmetry, combination treatment of LeFort I osteotomy and mandibular surgery was commonly used. This article demonstrates the usefulness of titanium screws for orthodontic anchorage to intrude the molars in 2 patients with facial asymmetry and canted occlusal plane.
The first patient was a woman, aged 29 years 6 months, with mandibular protrusion and canted occlusal plane; she was treated with molar intrusion and intraoral vertical ramus osteotomy. During presurgical orthodontic treatment, a titanium screw was implanted in the zygomatic process, and the molars were intruded for 6 months by using an elastic chain of 200 g. After intrusion, the molars were intruded 3.0 mm, and the canted maxillary occlusal plane was improved. The second patient was a young man, aged 16 years 5 months, with mandibular deviation and canted occlusal plane; he was treated with a combination of titanium screw anchorage and intraoral vertical ramus osteotomy. A miniscrew was implanted in the alveolar bone, and the orthodontic load began immediately after placement surgery by using an elastic chain. After 5 months of intrusion, the molars had been intruded by 3.0 mm.
Compared with 2-jaw surgery, this method of molar intrusion is less invasive, involves less psychological stress, is less expensive, and results in less postoperative discomfort. Therefore, treatment with titanium screws for molar intrusion to correct a canted occlusal plane could become a new treatment strategy for patients with facial asymmetry.
面部不对称是正畸患者的主要诉求。对于严重面部不对称的患者，通常采用LeFort I型截骨术和下颌手术联合治疗。本文展示了钛钉在正畸支抗中用于压低磨牙的有效性，该方法应用于2例面部不对称且咬合平面倾斜的患者。
首例患者为一名29岁6个月的女性，有下颌前突和咬合平面倾斜；她接受了磨牙压低和口内垂直升支截骨术治疗。在术前正畸治疗期间，在颧突植入一枚钛钉，使用200g的弹力链压低磨牙6个月。压低后，磨牙压低了3.0mm，上颌倾斜的咬合平面得到改善。第二例患者是一名16岁5个月的年轻男性，有下颌偏斜和咬合平面倾斜；他接受了钛钉支抗联合口内垂直升支截骨术治疗。在牙槽骨植入一枚微型钛钉，植入手术后立即通过弹力链施加正畸力。压低5个月后，磨牙压低了3.0mm。
与双颌手术相比，这种磨牙压低方法侵入性更小，心理压力更小，费用更低，术后不适更少。因此，用钛钉压低磨牙以纠正倾斜的咬合平面可能成为面部不对称患者的一种新的治疗策略。
