Lombardo Luca, Palone Mario, Maino Giuliano, Paoletto Emanuele, Carlucci Antonella, Siciliani Giuseppe
Angle Orthod. 2021 Jan 1;91(1):129-137. doi: 10.2319/050520-394.1.
This case report describes orthodontic treatment including both skeletal maxillary expansion and unilateral distalization by means of a single bone-borne appliance followed by clear aligner therapy in a young adult patient. A surgical guide was digitally designed and three-dimensionally printed to facilitate the placement of four miniscrews in the palatal vault. The miniscrews were fitted and the bone-borne appliance was delivered in a single clinical appointment. The postexpansion photographic records and models demonstrate the opening of the palatal median suture, the pure skeletal expansion, and the resolution of the left crossbite after 40 activations. Specifically, left molar Class I was obtained in about 5 months without any loss of anterior anchorage, and the subsequent aligner phase achieved all of the objectives established in the treatment plan. This case report shows clearly how careful digital planning of miniscrew insertion and the delivery of a pure bone-borne appliance in a single sitting enabled good clinical outcomes to be achieved in an acceptable timeframe, without side effects, even in a young adult patient.
本病例报告描述了一名年轻成年患者的正畸治疗过程，该治疗包括使用单一骨支抗矫治器进行上颌骨骨骼扩展和单侧远中移动，随后进行透明矫治器治疗。通过数字化设计并三维打印了手术导板，以方便在上颌腭穹窿处植入4颗微型螺钉。在一次临床就诊中完成了微型螺钉的植入和骨支抗矫治器的佩戴。扩弓后的照片记录和模型显示，在进行40次加力后，腭中缝打开，实现了单纯的骨骼扩展，左侧反牙合得到矫正。具体而言，在约5个月内实现了左侧磨牙I类关系，且前牙支抗未出现任何丧失，随后的矫治器阶段实现了治疗计划中设定的所有目标。本病例报告清楚地表明，通过精心的数字化规划微型螺钉植入并在一次就诊中佩戴单纯的骨支抗矫治器，即使是年轻成年患者，也能在可接受的时间范围内取得良好的临床效果，且无副作用。
