Ikeda Yuhei, Kokai Satoshi, Ono Takashi
Department of Orthodontic Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
Department of Orthodontic Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
Am J Orthod Dentofacial Orthop. 2018 Jan;153(1):131-143. doi: 10.1016/j.ajodo.2017.07.016.
Skeletal and dental discrepancies cause asymmetric malocclusions in orthodontic patients. It is difficult to achieve adequate functional occlusion and guidance in patients with congenital absence of a mandibular incisor due to the tooth-size discrepancy. Here, we describe the orthodontic treatment of a 22-year-old woman with an asymmetric Angle Class II malocclusion, mandibular deviation to the left, and 3 mandibular incisors. The anterior teeth and maxillary canines were crowded. We used an improved superelastic nickel-titanium alloy wire (Tomy International, Tokyo, Japan) to compensate for the asymmetric mandibular arch and an asymmetrically bent archwire to move the maxillary molars distally. A skeletal anchorage system provided traction for intermaxillary elastics, and extractions were not needed. We alleviated the crowding and created an ideal occlusion with proper overjet, overbite, and anterior guidance with Class I canine and molar relationships. This method of treatment with an asymmetrically bent nickel-titanium alloy wire provided proper Class I occlusion and anterior guidance despite the mandibular deviation to the left and 3 mandibular incisors, without the need for extractions.
骨骼和牙齿差异会导致正畸患者出现不对称错牙合畸形。由于牙齿大小差异，先天性下颌切牙缺失的患者很难实现足够的功能咬合和引导。在此，我们描述了一名22岁女性的正畸治疗情况，该患者患有不对称安氏II类错牙合畸形，下颌向左偏斜，有3颗下颌切牙。前牙和上颌尖牙拥挤。我们使用了一种改进的超弹性镍钛合金丝（日本东京东发株式会社）来补偿不对称的下颌牙弓，并使用一根不对称弯曲的弓丝将上颌磨牙向远中移动。一种骨锚固系统为颌间弹力牵引提供了牵引力，无需拔牙。我们缓解了拥挤情况，并通过I类尖牙和磨牙关系建立了具有适当覆盖、覆牙合和前牙引导的理想咬合。这种使用不对称弯曲镍钛合金丝的治疗方法，尽管下颌向左偏斜且有3颗下颌切牙，但仍能提供适当的I类咬合和前牙引导，且无需拔牙。
