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半侧下颌骨肥大采用下颌骨切除术和微型钢板正畸掩饰性治疗。

Hemimandibular hyperplasia treatment with condylectomy and orthodontic camouflage treatment using miniplate.

机构信息

Department of Orthodontics, School of Dentistry, Wonkwang University, Iksan, South Korea.

Postgraduate Orthodontic Program, Arizona School of Dentistry & Oral Health, A.T. Still University, Mesa, Ariz; Graduate School of Dentistry, Kyung Hee University, Seoul, South Korea.

出版信息

Am J Orthod Dentofacial Orthop. 2021 Jun;159(6):852-865.e5. doi: 10.1016/j.ajodo.2020.10.026. Epub 2021 Apr 24.

Abstract

A 13-year-old growing female patient presented with hemimandibular hyperplasia of the right side, Class III hypodivergent skeletal pattern, and severe facial asymmetry. Corrective surgery was deferred until her growth had been completed. When the patient was 16 years old, a low condylectomy was performed on the hyperplastic side of her mandible to prevent its progressive condylar hyperplasia, while simultaneous orthodontic camouflage treatment was performed with the intrusion of the maxillary right posterior teeth using temporary skeletal anchorage devices without additional orthognathic surgery. A low condylectomy caused anterior and lateral open bite after the downward and backward movement of the chin, which improved Class III appearance. The intrusion of the maxillary right posterior teeth followed by compensating extrusion of the mandibular posterior teeth contributed to improve the patient's facial asymmetry with correction of the transverse occlusal plane and lip canting. After 30 months of treatment, an acceptable esthetic outcome and functional occlusion were achieved. The treatment results were well maintained for 1-year retention.

摘要

一位 13 岁的女性患者,右侧下颌骨偏侧性肥大,表现为 III 类低角型骨骼不调,且存在严重的面部不对称。由于患者仍处于生长发育期,因此手术矫正被推迟。当患者 16 岁时,在其下颌骨肥大侧行下颌升支低位切除术,以防止髁突进行性过度生长,同时使用临时骨支抗装置内收上颌右侧后牙,进行同期正畸掩饰性治疗,无需额外的正颌手术。颏部向下向后移动后,行下颌升支低位切除术导致前牙及侧方开合,从而改善了 III 类面型。上颌右侧后牙的内收以及下颌后牙的补偿性外展有助于改善患者的面部不对称,同时纠正了横向牙合平面和唇倾。治疗 30 个月后,患者获得了可接受的美学效果和功能牙合。1 年的保持期过后,治疗效果保持良好。

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