Starch-Jensen Thomas, Kjellerup Annette Dalgaard
Department of Oral and Maxillofacial Surgery, Aalborg University Hospital, Aalborg, Denmark.
Open Dent J. 2018 Sep 28;12:623-630. doi: 10.2174/1745017901814010623. eCollection 2018.
Skeletal Angle Class I patients with a severe dental Class II malocclusion are characterized by an unfavourable anterior-posterior relationship between the anterior dentoalveolar area and the skeletal base. Orthodontic alignment posing various treatment difficulties and surgical correction with bilateral sagittal split osteotomy may result in a compromised facial profile. Hence, anterior mandibular segmental distraction osteogenesis has been proposed as an alternative treatment modality for solving facial esthetics, anterior tooth crowding and an unfavourable relationship between the anterior dentoalveolar area and the skeletal base in skeletal Angle Class I patients with a severe dental Class II malocclusion. Limited skeletal relapse with predictable soft tissue changes have been documented in long-term studies. Thus, anterior mandibular segmental distraction osteogenesis seems to be a valuable and predictable surgical method for correction of selected cases of skeletal Class I patients with a severe dental Class II malocclusion.
The purpose of this case report is to present the treatment of a 57-year-old female with a skeletal Angle Class I relation and a severe dental Class II malocclusion. Anterior mandibular segmental distraction osteogenesis as well as discussing the current knowledge about this treatment modality.
The present case report illustrates that establishment of a harmonious relationship between the maxillary and mandibular arch in patients with a skeletal Angle Class I relation and a severe dental Class II malocclusion using anterior mandibular segmental distraction osteogenesis seems to be a predictable and applicable surgical method for selected cases and General Dental Practitioners, orthodontics and maxillofacial surgeons must have knowledge of this treatment modality.
骨骼I类错颌畸形且伴有严重牙性II类错颌的患者，其前牙牙槽区域与骨骼基底之间存在不利的前后关系。正畸排牙存在各种治疗难题，而双侧矢状劈开截骨术进行手术矫正可能会导致面部轮廓受损。因此，有人提出下颌前部节段性牵张成骨术可作为一种替代治疗方式，用于解决骨骼I类错颌畸形且伴有严重牙性II类错颌患者的面部美观、前牙拥挤以及前牙牙槽区域与骨骼基底之间的不利关系问题。长期研究记录了有限的骨骼复发以及可预测的软组织变化。因此，下颌前部节段性牵张成骨术似乎是一种有价值且可预测的手术方法，用于矫正部分骨骼I类错颌畸形且伴有严重牙性II类错颌的病例。
本病例报告的目的是介绍一名57岁女性患者的治疗情况，该患者为骨骼I类关系且伴有严重牙性II类错颌。采用下颌前部节段性牵张成骨术，并讨论有关这种治疗方式的现有知识。
本病例报告表明，对于骨骼I类关系且伴有严重牙性II类错颌的患者，使用下颌前部节段性牵张成骨术在上颌和下颌牙弓之间建立和谐关系，对于部分病例似乎是一种可预测且适用的手术方法，普通牙科医生、正畸医生和颌面外科医生必须了解这种治疗方式。
