Angle Orthod. 2022 Mar 1;92(2):287-293. doi: 10.2319/040521-272.1.
Treatment of hyperdivergent skeletal Class III malocclusion is challenging for orthodontists, and orthognathic-orthodontic treatment is usually required. This report presents the successful nonsurgical treatment of a 20-year-old man who had a skeletal Class III malocclusion with anterior open bite, anterior and posterior crossbite, hyperdivergent growth pattern, steep occlusal plane, early loss of three first molars, and an uncommon convex profile with a retruded chin. An orthodontic camouflage treatment plan was chosen based on the etiology and the patient's complaints. Tooth #37 was extracted. Miniscrews were used for uprighting and intruding of the lower molars, distalization of the lower dentition, and flattening of the occlusal plane. After 34 months of active treatment, Class I relationships, proper anterior overjet and overbite, flat occlusal plane, and an esthetic facial profile were achieved. The results demonstrated that the biomechanics involved in the nonsurgical treatment assisted with miniscrews to distalize the mandibular dentition and flatten the occlusal plane while keeping the mandibular plane stable was effective for treating this hyperdivergent skeletal Class III patient with a convex profile and anterior open bite.
治疗严重高角骨性 III 类错(牙合)畸形对正畸医生来说具有挑战性,通常需要正颌 - 正畸联合治疗。本报告介绍了一位 20 岁男性患者的成功非手术治疗案例,该患者存在骨性 III 类错(牙合)畸形伴前牙开(牙合)、前牙及后牙反(牙合)、高角生长型、陡的咬合平面、3 颗第一恒磨牙早失以及凸面型伴后缩颏畸形。根据病因和患者诉求选择了正畸掩饰性治疗方案。拔除了 #37 牙。使用微型种植体支抗来直立和内倾下颌磨牙、远中移动下颌牙列以及压平咬合平面。经过 34 个月的主动治疗,患者实现了 I 类颌关系、适当的前牙覆盖和覆(牙合)、平坦的咬合平面以及美观的面型。结果表明,非手术治疗中涉及的生物力学通过微型种植体支抗远中移动下颌牙列和压平咬合平面,同时保持下颌平面稳定,对于治疗这种凸面型前牙开(牙合)的严重高角骨性 III 类患者是有效的。