Pinho Teresa, Rocha Duarte, Gonçalves Sara, Martins Maria Luís
UNIPRO-Oral Pathology and Rehabilitation Research Unit, University Institute of Health Sciences (IUCS), CESPU, 4585-116 Gandra, Portugal.
IBMC-Instituto Biologia Molecular e Celular, i3S-Inst. Inovação e Investigação em Saúde, Universidade do Porto, Porto, Portugal.
Case Rep Dent. 2024 Feb 23;2024:8841829. doi: 10.1155/2024/8841829. eCollection 2024.
Scissor bite does not correct spontaneously. It gradually worsens by overeruption, negatively affecting masticatory function. It is intended with this manuscript to evaluate the different treatment strategies to correct this malocclusion in adult patients, exploring treatment with clear aligners, bite ramps, and MS (miniscrews), especially in this case of a patient with unilateral right scissor bite, with high dental compensation in the three planes of space, asymmetrical sagittal dental position, overeruption on the scissor bite condition, and a high mandibular arch constriction and maxillary expansion. A comprehensive literature research was performed from 2002 until March 2023. PubMed and BVS databases were used, with the following keywords: "scissor bite OR brodie bite" AND "malocclusion" AND "treatment OR correction OR therapeutics". Since correcting skeletal asymmetries after the growth completion is challenging, adult patient cases often involve a combined orthodontic-surgical approach. In the present clinical case, the severe limitations to decompensating tooth positions for a surgical treatment, with the necessity to perform lower asymmetric extraction and a must longer orthodontic treatment, were the major reasons to avoid the surgical approach, after the scissor bite correction. In spite of this, the efficiency of the clear aligners and auxiliaries like bite ramps, MS, and elastics in successfully correcting a complex scissor bite in an adult patient was demonstrated, with significant esthetic and functional commitment, demonstrated by the case reliability PAR (peer assessment rating) index.
剪刀式咬合不会自发矫正。它会因牙齿过度萌出而逐渐加重,对咀嚼功能产生负面影响。本文旨在评估成年患者矫正这种错牙合畸形的不同治疗策略,探索使用透明矫治器、咬合斜面导板和微螺钉(miniscrews)进行治疗,特别是针对一名右侧单侧剪刀式咬合的患者,该患者在三维空间中存在高度牙齿代偿、矢状位牙齿不对称、剪刀式咬合情况下的牙齿过度萌出以及下颌牙弓严重缩窄和上颌扩弓。从2002年至2023年3月进行了全面的文献研究。使用了PubMed和BVS数据库,关键词如下:“剪刀式咬合或布罗迪咬合”以及“错牙合畸形”以及“治疗或矫正或疗法”。由于生长完成后矫正骨骼不对称具有挑战性,成年患者病例通常涉及正畸 - 外科联合治疗方法。在本临床病例中,手术治疗时牙齿去代偿的严重局限性,包括需要进行下颌不对称拔牙以及必须进行更长时间的正畸治疗,是在矫正剪刀式咬合后避免采用手术方法的主要原因。尽管如此,通过病例可靠性PAR(同行评估评级)指数证明,透明矫治器以及诸如咬合斜面导板、微螺钉和弹力牵引等辅助装置在成功矫正成年患者复杂的剪刀式咬合方面具有有效性,同时具有显著的美学和功能效果。