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伴有侧切牙先天缺失和未萌出尖牙的Ⅲ类错牙合畸形的外科正畸治疗

Surgical-orthodontic treatment of Class III malocclusion with agenesis of lateral incisor and unerupted canine.

作者信息

Vieira Bruno Boaventura, Sanguino Ana Carolina Meng, Moreira Marilia Rodrigues, Morizono Elizabeth Norie, Matsumoto Mírian Aiko Nakane

出版信息

Dental Press J Orthod. 2013 May-Jun;18(3):94-100. doi: 10.1590/s2176-94512013000300015.

Abstract

INTRODUCTION

Orthodontic-surgical treatment was performed in patient with skeletal Class III malocclusion due to exceeding mandibular growth. Patient also presented upper and lower dental protrusion, overjet of -3.0 mm, overbite of -1.0 mm, congenital absence of tooth #22, teeth #13 and supernumerary impaction, tooth #12 with conoid shape and partly erupted in supraversion, prolonged retention of tooth #53, tendency to vertical growth of the face and facial asymmetry. The discrepancy on the upper arch was -2.0 mm and -5.0 mm on the lower arch.

METHODS

The presurgical orthodontic treatment was performed with extraction of the teeth #35 and #45. On the upper arch, teeth #53, #12 and supernumerary were extracted to accomplish the traction of the impacted canine. The spaces of the lower extractions were closed with mesialization of posterior segment. After aligning and leveling the teeth, extractions spaces closure and correct positioning of teeth on the bone bases, the correct intercuspation of the dental arch, with molars and canines in Angle's Class I, coincident midline, normal overjet and overbite and ideal torques, were evaluated through study models. The patient was submitted to orthognathic surgery and then the postsurgical orthodontic treatment was finished.

RESULTS

The Class III malocclusion was treated establishing occlusal and facial normal standards.

摘要

引言

对一名因下颌生长过度导致骨性Ⅲ类错牙合畸形的患者进行了正畸-外科治疗。患者还存在上下牙前突、覆盖-3.0mm、覆牙合-1.0mm、22号牙先天性缺失、13号牙和多生牙阻生、12号牙呈锥形且部分萌出并向牙合方倾斜、53号牙滞留时间延长、面部垂直生长趋势和面部不对称。上颌牙弓差异为-2.0mm,下颌牙弓为-5.0mm。

方法

术前正畸治疗拔除35号牙和4444号牙。在上颌,拔除53号牙、12号牙和多生牙以完成阻生尖牙的牵引。下颌拔牙间隙通过后段牙近中移动关闭。在排齐整平牙齿、关闭拔牙间隙并使牙齿在牙槽骨上正确定位后,通过研究模型评估牙弓的正确牙尖交错位,使磨牙和尖牙呈安氏Ⅰ类关系、中线一致、覆盖和覆牙合正常以及转矩理想。患者接受正颌外科手术,然后完成术后正畸治疗。

结果

Ⅲ类错牙合畸形得到治疗,建立了正常的咬合和面部标准。

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