Felicita A Sumathi, Chandrasekar Shyamala, Sundari K K Shantha
Department of Orthodontics, Saveetha Dental College, Chennai, India.
Aust Orthod J. 2011 Nov;27(2):181-90.
To describe the two-phase treatment of a preadolescent boy with a severe skeletal Class II division 1 malocclusion with vertical maxillary excess and spaced upper incisors.
Treatment involved an orthopaedic phase using high-pull headgear and a maxillary intrusion splint followed by non-extraction orthodontic treatment with a pre-adjusted edgewise appliance. The case was assessed at the start of treatment (T1), at the end of orthopaedic treatment (T2), at the end of orthodontic treatment (T3) and 2 years after debanding (T4).
At T2 the Class II molar occlusion was corrected to a Class I molar relationship and the overjet and overbite were considerably reduced. A lower lip trap was relieved and a normal mentolabial sulcus obtained. The cephalometric changes at T2 revealed a 4 degree reduction in the ANB angle but no change in the SNA angle. At T3, the inclination of the upper central incisors, the overjet and overbite were normal and the spaces between the upper anterior teeth were closed. At T4, the Class I molar and canine relationships, reduced overjet, reduced overbite and intercuspation were maintained. The curve of Spee deepened slightly.
A severe skeletal Class II division 1 malocclusion with vertical maxillary excess may be successfully treated in two phases with an initial orthopaedic appliance in the form of high-pull head gear and a maxillary intrusion splint followed by fixed appliances.
描述一名青春期前男孩严重骨性安氏II类1分类错牙合伴上颌垂直向发育过度及上颌前牙间隙的两阶段治疗过程。
治疗包括使用高位牵引头帽和上颌压低矫治器的矫形阶段，随后使用预成直丝弓矫治器进行非拔牙正畸治疗。在治疗开始时（T1）、矫形治疗结束时（T2）、正畸治疗结束时（T3）以及解除矫治器后2年（T4）对病例进行评估。
在T2时，II类磨牙关系矫正为I类磨牙关系，覆盖和覆牙合明显减小。下唇陷得到缓解，颏唇沟正常。T2时的头影测量变化显示ANB角减小4度，但SNA角无变化。在T3时，上颌中切牙倾斜度、覆盖和覆牙合正常，上颌前牙间隙关闭。在T4时，I类磨牙和尖牙关系、减小的覆盖、减小的覆牙合和牙尖交错关系得以维持。Spee曲线略有加深。
严重骨性安氏II类1分类错牙合伴上颌垂直向发育过度可通过两个阶段成功治疗，初始采用高位牵引头帽和上颌压低矫治器形式的矫形矫治器，随后使用固定矫治器。
