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在一例成人高角病例中,使用微型螺钉辅助直丝弓技术非手术矫治严重的前牙深覆合伴露龈笑和后牙剪刀合。

Nonsurgical correction of a severe anterior deep overbite accompanied by a gummy smile and posterior scissor bite using a miniscrew-assisted straight-wire technique in an adult high-angle case.

作者信息

Wang Xue-Dong, Zhang Jie-Ni, Liu Da-Wei, Lei Fei-Fei, Zhou Yan-Heng

机构信息

Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, China.

Private Practice, Shen Zhen, China.

出版信息

Korean J Orthod. 2016 Jul;46(4):253-65. doi: 10.4041/kjod.2016.46.4.253. Epub 2016 Jul 25.

Abstract

In the present report, we describe the successful use of miniscrews to achieve vertical control in combination with the conventional sliding MBT™ straight-wire technique for the treatment of a 26-year-old Chinese woman with a very high mandibular plane angle, deep overbite, retrognathic mandible with backward rotation, prognathic maxilla, and gummy smile. The patient exhibited skeletal Class II malocclusion. Orthodontic miniscrews were placed in the maxillary anterior and posterior segments to provide rigid anchorage and vertical control through intrusion of the incisors and molars. Intrusion and torque control of the maxillary incisors relieved the deep overbite and corrected the gummy smile, while intrusion of the maxillary molars aided in counterclockwise rotation of the mandibular plane, which consequently resulted in an improved facial profile. After 3.5 years of retention, we observed a stable, well-aligned dentition with ideal intercuspation and more harmonious facial contours. Thus, we were able to achieve a satisfactory occlusion, a significantly improved facial profile, and an attractive smile for this patient. The findings from this case suggest that nonsurgical correction using miniscrew anchorage is an effective approach for camouflage treatment of high-angle cases with skeletal Class II malocclusion.

摘要

在本报告中,我们描述了成功使用微型螺钉结合传统的滑动MBT™直丝弓技术实现垂直控制,以治疗一名26岁的中国女性。该患者下颌平面角非常高,深覆合,下颌后缩并向后旋转,上颌前突,露龈笑,表现为骨性II类错牙合。在上颌前后段植入正畸微型螺钉,通过切牙和磨牙的压低提供刚性支抗和垂直控制。上颌切牙的压低和转矩控制减轻了深覆合并纠正了露龈笑,而上颌磨牙的压低有助于下颌平面逆时针旋转,从而改善面部轮廓。经过3.5年的保持,我们观察到牙列稳定、排列整齐,具有理想的牙尖交错关系,面部轮廓更加和谐。因此,我们能够为该患者实现令人满意的咬合、显著改善的面部轮廓和迷人的微笑。该病例的研究结果表明,使用微型螺钉支抗的非手术矫治是一种治疗骨性II类错牙合高角病例的有效掩饰性治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5a08/4965596/504a1c17da38/kjod-46-253-g001.jpg

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