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Ⅲ类错颌正畸掩饰治疗:“理想”治疗总是最佳选择吗?一份病例报告

Class III Orthodontic Camouflage: Is the "Ideal" Treatment Always the Best Option? A Documented Case Report.

作者信息

Rustico Lorenzo, Ronsivalle Vincenzo, Iaculli Flavia, Spagnuolo Gianrico, Isola Gaetano, Giudice Antonino Lo

机构信息

Department of Medical-Surgical Specialties, School of Dentistry, University of Catania, Policlinico Universitario "G. Rodolico", Via Santa Sofia 78, 95123 Catania, Italy.

Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico II", Via Pansini 5, 80131 Naples, Italy.

出版信息

Case Rep Dent. 2022 Jul 12;2022:9200469. doi: 10.1155/2022/9200469. eCollection 2022.

Abstract

Angle's Class III is one of the most complex malocclusions to treat. In nongrowing skeletal class III malocclusions, the choice between orthognathic surgery and camouflage treatment remains a challenge to the orthodontist. In class III borderline cases, clinicians are called to find the best compromise between functional and aesthetics outcomes, with the latter which often turns in avoiding worsening of profile characteristics, which makes the treatment of these patients quite challenging. This case report describes a borderline nongrowing patient with skeletal class III malocclusion, upper incisor proclination and spacing, lower crowding, and arch width discrepancy, which has already undergone previous orthodontic treatment. The orthodontic treatment involved the mandibular first premolar extraction, resulting in class I canine relation with good overjet and overbite as well as good arch coordination. The orthodontic camouflage improved the dental relationship with normalization of upper incisor inclination without a relevant retroclination of lower incisors; the skeletal facial pattern of the patient experienced a slight improvement. The tendency to skeletal class III has remained nearly unaffected. Treatment outcomes were stable after 1-year posttreatment follow-up.

摘要

安氏III类错颌是最难治疗的错颌畸形之一。在非生长型骨性III类错颌中,正颌外科手术和掩饰性治疗之间的选择对正畸医生来说仍然是一个挑战。在III类临界病例中,临床医生需要在功能和美学效果之间找到最佳平衡,而后者往往意味着避免面部轮廓特征的恶化,这使得这些患者的治疗极具挑战性。本病例报告描述了一名非生长型临界患者,患有骨性III类错颌、上切牙前倾和间隙、下牙列拥挤以及牙弓宽度差异,该患者之前已经接受过正畸治疗。正畸治疗包括拔除下颌第一前磨牙,最终实现了I类尖牙关系,覆盖和覆合良好,牙弓协调性也良好。正畸掩饰性治疗改善了牙颌关系,上切牙倾斜度恢复正常,下切牙没有明显后倾;患者的骨性面部形态略有改善。III类骨性倾向几乎没有改变。治疗后1年的随访结果显示治疗效果稳定。

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