School of Stomatology, Nanchang University & Jiangxi Province Clinical Research Center for Oral Diseases & Jiangxi Province Key Laboratory of Oral Biomedicine, No. 49, Fuzhou Road, Nanchang 330006, Jiangxi, China.
School of Stomatology, Nanchang University & Jiangxi Province Clinical Research Center for Oral Diseases & Jiangxi Province Key Laboratory of Oral Biomedicine, No. 49, Fuzhou Road, Nanchang 330006, Jiangxi, China.
Int Orthod. 2023 Jun;21(2):100756. doi: 10.1016/j.ortho.2023.100756. Epub 2023 May 9.
This case report illustrates the successful nonsurgical and nonextraction treatment of a 12-year-old boy with skeletal Class II deep bite malocclusion undergoing two-phase clear aligner treatment. During A6 mandibular advancement phase, Class II buccal segment relationship was corrected by differential forward growth of the mandible, unplanned distalization of maxillary posterior teeth, and unplanned mesialization of mandibular posterior teeth. The maxillary sagittal curve of occlusion was deepened, the mandibular curve of Spee was not fully levelled, and the maxillary arch experienced downward-backward rotation resulting in premature contact on anterior and posterior open bite. Buccal crown tipping of maxillary posterior teeth was observed after arch expansion. The forward growth of the mandible improved the skeletal relationship, and the advancement of the chin position and sagittal movements of the incisors altered the nose-lip-chin relationship, resulting in an improved profile of the patient. During refinement phase, the posterior open bite was corrected. The mandibular plane angle did not increase throughout the treatment. The patient was satisfied with the aesthetic and functional outcome.
本病例报告说明了一例骨骼 II 类深覆颌畸形的 12 岁男孩经两阶段透明牙套治疗成功实现非手术、不拔牙的治疗过程。在 A6 下颌前伸阶段,通过下颌的差异前伸生长、上颌后牙的非计划远移和下颌后牙的非计划近中移动,纠正了 II 类颊侧段关系。上颌咬合的矢状曲线加深,Spee 下颌曲线未完全调平,上颌弓经历向下向后旋转,导致前牙和后牙开合时过早接触。扩弓后观察到上颌后牙颊面冠倾斜。下颌的前伸生长改善了骨骼关系,颏部位置的前伸和切牙矢状移动改变了鼻唇角关系,使患者的面型得到改善。在精细调整阶段,纠正了后牙开合。整个治疗过程中下颌平面角没有增加。患者对治疗的美观和功能效果满意。