Private Practice, Golden Valley, Minn; Division of Orthodontics, University of Minnesota, Minneapolis, Minn.
Am J Orthod Dentofacial Orthop. 2020 Jun;157(6):832-842. doi: 10.1016/j.ajodo.2019.03.031.
Maxillary LeFort impaction surgery can lead to improvements in facial proportions, smile esthetics, and improved function for patients with long lower facial height and anterior open bite. Sometimes, because of patient wishes, corrective jaw surgery might not be the most appropriate choice for treatment. This report describes the orthodontic retreatment of a 25-year-old woman with a history of 2 orthodontic treatments and 1 corrective jaw surgery, each with anterior open bite relapse. This third orthodontic treatment plan addressed her chief concern and focused on maximizing esthetics, function, and long-term stability. A problem list was used to design a treatment plan that incorporated myofunctional therapy, fixed appliances, and temporary anchorage devices to intrude her maxillary teeth and correct her orthodontic problems. Molar intrusion lasted 8.5 months, and total treatment time in fixed appliances lasted 22 months. The treatment was successful in addressing her chief concerns by shortening her lower facial third, relieving her lip strain, closing her anterior open bite, and achieving a Class I molar and canine occlusion. Overall, posttreatment stability was excellent at approximately 1-year follow-up, and the patient stated that she was very happy with the result.
上颌 LeFort 骨折内推术可以改善面下部高度过长和前牙开颌患者的面部比例、微笑美观和功能。有时，由于患者的意愿，矫正颌骨手术可能不是治疗的最佳选择。本报告介绍了一位 25 岁女性的正畸再治疗，她有 2 次正畸治疗和 1 次正颌手术史，每次都有前牙开颌复发。第三次正畸治疗方案主要关注美观、功能和长期稳定性，解决了她的主要问题。使用问题列表来设计治疗计划，该计划包括肌功能治疗、固定矫治器和临时支抗装置，以推上颌牙齿并纠正正畸问题。磨牙内倾持续了 8.5 个月，固定矫治器的总治疗时间为 22 个月。通过缩短面下部三分之一、缓解唇肌紧张、关闭前牙开颌以及实现Ⅰ类磨牙和尖牙咬合，治疗成功地解决了她的主要问题。总体而言，大约 1 年的随访后，治疗后的稳定性非常好，患者表示对结果非常满意。
