Am J Orthod Dentofacial Orthop. 2010 Feb;137(2):274-84. doi: 10.1016/j.ajodo.2009.07.009.
Early Class III treatment with reverse-pull headgear generally results in maxillary skeletal protraction but is frequently also accompanied by unfavorable dentoalveolar effects. An alternative treatment with intermaxillary elastics from a temporary anchorage device might permit equivalent favorable skeletal changes without the unwanted dentoalveolar effects.
Six consecutive patients (3 boys, 3 girls; ages, 10-13 years 3 months) with Class III occlusion and maxillary deficiency were treated by using intermaxillary elastics to titanium miniplates. Cone-beam computed tomography scans taken before and after treatment were used to create 3-dimensional volumetric models that were superimposed on nongrowing structures in the anterior cranial base to determine anatomic changes during treatment.
The effect of the intermaxillary elastic forces was throughout the nasomaxillary structures. All 6 patients showed improvements in the skeletal relationship, primarily through maxillary advancement with little effect on the dentoalveolar units or change in mandibular position.
The use of intermaxillary forces applied to temporary anchorage devices appears to be a promising treatment method.
早期使用反向牵引头帽进行 III 类治疗通常会导致上颌骨前突,但通常也会伴有不利的牙颌效应。使用临时锚固装置的颌间弹性体进行替代治疗可能会产生等效的有利骨骼变化,而不会产生不必要的牙颌效应。
6 名连续患者(3 名男孩,3 名女孩;年龄 10-13 岁 3 个月)患有 III 类错颌和上颌骨发育不全,通过使用颌间弹性体到钛迷你板进行治疗。治疗前后拍摄的锥形束计算机断层扫描 (CBCT) 扫描用于创建 3 维体积模型,并在前颅底的非生长结构上叠加,以确定治疗期间的解剖变化。
颌间弹性体的作用贯穿整个鼻上颌结构。所有 6 名患者的骨骼关系均得到改善,主要通过上颌前突实现,对牙颌单位几乎没有影响,下颌位置也没有变化。
使用临时锚固装置施加的颌间力似乎是一种有前途的治疗方法。