Choi Dong-Soon, Lee Dong-Hyun, Jang Insan, Cha Bong-Kuen
Department of Orthodontics, College of Dentistry, Gangneung-Wonju National University, Gangneung, Korea.
Korean J Orthod. 2022 May 6;52(5):362-371. doi: 10.4041/kjod22.023.
Orthognathic surgery is the primary treatment option for severe skeletal discrepancy. However, orthodontic camouflage should be considered as an alternative treatment option, considering the risks of surgery. A 19.5-year-old man presented with a severe prognathic mandible with a Class III molar relationship and an anterior crossbite. Orthognathic surgery could be considered because of his severe skeletal discrepancy and mandibular prognathism. However, the anesthetist for orthognathic surgery did not recommend surgery under general anesthesia because of risk factors associated with the patient's aplastic anemia, including bleeding and infections. Thus, a camouflage treatment to promote backward rotation of the mandible via orthodontic extrusion of the posterior teeth was planned. An anterior bite plate, intermaxillary elastics, and fixed orthodontic appliances were used to extrude the posterior teeth and to align the dentition. After 17 months of nonsurgical orthodontic treatment, normal occlusion was achieved, and the facial profile was dramatically improved. This case report describes the dentoskeletal and soft-tissue effects of mandibular rotation and its long-term stability.
正颌外科手术是严重骨骼畸形的主要治疗选择。然而，考虑到手术风险，正畸掩饰治疗应被视为一种替代治疗选择。一名19.5岁男性，表现为严重的下颌前突，伴有III类磨牙关系和前牙反合。由于其严重的骨骼畸形和下颌前突，可考虑正颌外科手术。然而，正颌外科手术的麻醉师因患者再生障碍性贫血相关的危险因素，包括出血和感染，不建议在全身麻醉下进行手术。因此，计划通过正畸压低后牙促进下颌向后旋转的掩饰治疗。使用前牙咬合板、颌间弹力牵引和固定正畸矫治器压低后牙并排齐牙列。经过17个月的非手术正畸治疗，实现了正常咬合，面部轮廓得到显著改善。本病例报告描述了下颌旋转的牙骨骼和软组织效应及其长期稳定性。
