Qamruddin Irfan, Shahid Fazal, Alam Mohammad Khursheed, Zehra Jamal Wafa
Orthodontic Department, Baqai Medical University, Karachi 74600, Pakistan.
Orthodontic Unit, School of Dental Science, Universiti Sains Malaysia, Kubang Kerian, 16150 Kota Bharu, Kelantan, Malaysia.
Case Rep Dent. 2014;2014:382367. doi: 10.1155/2014/382367. Epub 2014 Dec 7.
Skeletal class II has always been a challenge in orthodontics and often needs assistance of surgical orthodontics in nongrowing patients when it presents with severe discrepancy. Difficulty increases more when vertical dysplasia is also associated with sagittal discrepancy. The advent of mini implants in orthodontics has broadened the spectrum of camouflage treatment. This case report presents a 16-year-old nongrowing girl with severe class II because of retrognathic mandible, and anterior dentoalveolar protrusion sagittally and vertically resulted in severe overjet of 13 mm and excessive display of incisors and gums. Both maxillary central incisors were trimmed by general practitioner few years back to reduce visibility. Treatment involved use of micro implant for retraction and intrusion of anterior maxillary dentoalveolar segment while lower incisors were proclined to obtain normal overjet, and overbite and pleasing soft tissue profile. Smile esthetics was further improved with composite restoration of incisal edges of both central incisors.
骨性II类错颌在正畸治疗中一直是个挑战，对于非生长发育期的患者，当出现严重的牙颌面不调时，往往需要外科正畸的辅助。当垂直发育异常同时伴有矢状向不调时，难度会进一步增加。正畸微型种植体的出现拓宽了掩饰性治疗的范围。本病例报告介绍了一名16岁的非生长发育期女孩，因下颌后缩导致严重的骨性II类错颌，前牙牙槽突在矢状向和垂直向的突出导致13毫米的严重覆盖以及切牙和牙龈的过度显露。几年前全科医生对两颗上颌中切牙进行了修整以减少外露。治疗采用微型种植体来内收和压低上颌前牙牙槽段，同时唇倾下切牙以获得正常的覆盖、覆颌以及良好的软组织侧貌。通过对两颗中切牙切缘进行复合树脂修复，进一步改善了微笑美学效果。
