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微型钢板在治疗高角、双咬合、安氏II类错牙合中的应用。

The Use of Mini-Plates for the Treatment of a High-Angle, Dual Bite, Class II Malocclusion.

作者信息

Alves Celha Borges Costa, Silva Maria Alves Garcia Santos, Neto José Valladares

机构信息

Postgraduate Program in Dentistry, Federal University of Goiás School of Dentistry, Goiânia, Goiás, Brazil.

Department of Oral Diagnosis, Federal University of Goiás School of Dentistry, Goiânia, Goiás, Brazil.

出版信息

Turk J Orthod. 2019 Mar;32(1):52-58. doi: 10.5152/TurkJOrthod.2018.18029. Epub 2019 Jan 8.

Abstract

To present a case report of an orthodontic treatment of a high-angle, dual bite, Class II malocclusion without extractions and with the use of mini-plates. Class II malocclusion treatment protocols vary according to the morphological component of the malocclusion and the magnitude and direction of craniofacial growth. It is generally agreed that the cooperation of the patient and careful planning of anchorage are the key determinants of successful treatment. Protrusion of the upper and lower lip and a retrognathic mandible were the patient's chief concerns. The patient had learned to project her mandible forward to disguise the overjet. The patient's parents elected to correct the malocclusion with the use of bilateral infrazygomatic mini-plates. Pre-treatment condylar stabilization with an orthotic established a stable centric relation position, followed by mounting of the models on a semi-adjustable Panadent articulator. This allowed diagnosis and treatment planning from a stable condylar position and eliminated possible misdiagnosis due to the dual bite. Distal retraction and vertical control of the upper teeth enabled correction of the Class II malocclusion with minimal patient cooperation. Mini-plate-assisted treatment corrected the excessive overbite and overjet. The patient completed treatment with a stable occlusion and no longer postured her jaw forward. The parents and patient were completely satisfied with the positive treatment outcome. A 2-year follow-up confirmed the clinical stability.

摘要

报告一例高角、双咬合、安氏II类错牙合畸形的正畸治疗病例,该治疗未拔牙且使用了微型钛板。安氏II类错牙合畸形的治疗方案因错牙合畸形的形态成分以及颅面生长的幅度和方向而异。普遍认为,患者的配合以及仔细的支抗设计是成功治疗的关键决定因素。患者主要关心的是上下唇前突和下颌后缩。患者已学会将下颌向前伸以掩饰前牙覆盖。患者父母选择使用双侧颧下微型钛板矫治错牙合畸形。用矫治器进行治疗前髁突稳定,确立稳定的正中关系位,随后将模型上架到半可调式Panadent牙合架上。这使得能从稳定的髁突位置进行诊断和治疗计划制定,并消除了因双咬合导致的可能误诊。上牙的远中移动和垂直控制使得在患者配合极少的情况下矫治了安氏II类错牙合畸形。微型钛板辅助治疗纠正了过度的覆牙合和覆盖。患者完成治疗后咬合稳定,不再前伸下颌。父母和患者对积极的治疗效果完全满意。2年随访证实了临床稳定性。

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