Ogura Hiroki, Numazaki Kento, Oyanagi Toshihito, Seiryu Masahiro, Ito Arata, Noguchi Takahiro, Ohori Fumitoshi, Yoshida Michiko, Fukunaga Tomohiro, Kitaura Hideki, Mizoguchi Itaru
Division of Orthodontics and Dentofacial Orthopedics, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan.
J Clin Med. 2024 May 7;13(10):2753. doi: 10.3390/jcm13102753.
We investigated treatment outcomes and post-treatment stability in 10 patients with an anterior open bite and nonsurgical orthodontics. The patients underwent maxillary molar intrusion using temporary anchorage devices (TADs) to deepen the overbite due to mandibular autorotation. Lateral cephalograms and dental cast models were obtained before treatment (T0), immediately after it (T1), and >1 year after it (T2). Skeletal and dental cephalometric changes and three-dimensional movements of the maxillary dentitions were evaluated. At T0, cephalometric analysis indicated that patients had skeletal class I with tendencies for a class II jaw relationship and a skeletal open bite. During active treatment (T0 to T1), the maxillary first molar intruded by 1.6 mm, the mandibular first molar extruded by 0.3 mm, the Frankfort-mandibular plane angle decreased by 1.1°, and the overbite increased by 4.1 mm. Statistically significant changes were observed in the amount of vertical movement of the maxillary first molar, Frankfort-mandibular plane angle, and overbite. Three-dimensional (3D) dental cast analysis revealed that the maxillary first and second molars intruded, whereas the anterior teeth extruded, with the second premolar as an infection point. In addition, the maxillary molar was tipped distally by 2.9° and rotated distally by 0.91°. Statistically significant changes were observed in the amount of vertical movement of the central incisor, lateral incisor, canine and first molar, and molar angulation. From T1 to T2, no significant changes in cephalometric measurements or the 3D position of the maxillary dentition were observed. The maxillary and mandibular dentitions did not significantly change during post-treatment follow-up. Maxillary molar intrusion using mini-screws is an effective treatment for open bite correction, with the achieved occlusion demonstrating 3D stability at least 1 year after treatment.
我们研究了10例前牙开颌患者采用非手术正畸治疗的效果及治疗后的稳定性。患者使用临时锚固装置（TADs）进行上颌磨牙压低，以因下颌自动旋转加深覆合。在治疗前（T0）、治疗后即刻（T1）以及治疗后>1年（T2）获取头颅侧位片和石膏模型。评估骨骼和牙齿的头影测量变化以及上颌牙列的三维移动。在T0时，头影测量分析表明患者为骨骼I类，有II类颌关系倾向和骨骼性开颌。在积极治疗期间（T0至T1），上颌第一磨牙压低1.6 mm，下颌第一磨牙伸长0.3 mm，Frankfort-下颌平面角减小1.1°，覆合增加4.1 mm。在上颌第一磨牙垂直移动量、Frankfort-下颌平面角和覆合方面观察到有统计学意义的变化。三维（3D）石膏模型分析显示上颌第一和第二磨牙压低，而前牙伸长，以第二前磨牙为转折点。此外，上颌磨牙向远中倾斜2.9°并向远中旋转0.91°。在中切牙、侧切牙、尖牙和第一磨牙的垂直移动量以及磨牙角度方面观察到有统计学意义的变化。从T1到T2，头影测量值或上颌牙列的3D位置没有显著变化。治疗后随访期间上颌和下颌牙列没有明显变化。使用微型螺钉压低上颌磨牙是矫正开颌的有效治疗方法，治疗后至少1年所达到的咬合显示出3D稳定性。
