Tripathi Tulika, Kalra Shilpa, Rai Priyank
Department of Orthodontics and Dentofacial Orthopaedics, Maulana Azad Institute of Dental Sciences, New Delhi, India.
Dental Press J Orthod. 2020 Mar;25(2):24. doi: 10.1590/2177-6709.25.2.24.e1-9.onl. Epub 2020 May 29.
Skeletal Class III malocclusion with asymmetry is one of the most difficult problems to correct in orthodontics. A functional shift of the mandible in growing patients may occur accompanying a Class III, due to constricted maxillary arch and occlusal interferences. Studies have indicated that posterior unilateral crossbite develops early and has a low rate of spontaneous correction. It may further lead to development of mandibular and facial asymmetry by growth and displacement of mandible if left untreated in growing patients.
This article reports the clinical case of a thirteen-year-old female patient in CVMI transition stage that had maxillary hypoplasia with a developing facial asymmetry.
The case was successfully managed with bone-anchored facemask therapy and with elimination of occlusal interferences with guided occlusion. Reverse twin block in the retention phase maintained the results achieved.
A four-year follow-up evaluation revealed successful maintenance of the treatment results.
伴有不对称的骨性Ⅲ类错牙合畸形是正畸治疗中最难矫治的问题之一。在生长发育期患者中，Ⅲ类错牙合畸形可能伴随上颌牙弓狭窄和咬合干扰而出现下颌功能性移位。研究表明，后牙单侧反牙合出现较早，且自行矫正率较低。如果在生长发育期患者中不进行治疗，它可能会通过下颌的生长和移位进一步导致下颌及面部不对称的发展。
本文报告了一名处于CVMI过渡期的13岁女性患者的临床病例，该患者存在上颌发育不足并伴有面部不对称的发展。
该病例通过骨锚式面罩治疗以及采用引导性咬合消除咬合干扰而成功得到处理。保持期使用反向双阻板维持了所取得的治疗效果。
四年的随访评估显示治疗效果得到成功维持。
