Anh Nguyen Viet, Ly Nguyen Thi Khanh, Viet Hoang, Marya Anand
Faculty of Dentistry, PHENIKAA University, Yen Nghia, Ha Dong, Hanoi 12116, Vietnam.
Faculty of Dentistry, Department of Orthodontics and Pedodontics, 45 Nguyễn Khắc Nhu, Phu'ò'ng Cô Giang, Quận 1, Hồ Chí Minh 700000, Vietnam.
J Surg Case Rep. 2024 Aug 10;2024(8):rjae496. doi: 10.1093/jscr/rjae496. eCollection 2024 Aug.
An iatrogenic open bite after orthognathic surgery is an uncommon malocclusion, with only one documented case reported in the literature. However, the open bite in this case report was not a true open bite, as it resulted from the interferences between the maxillary second molars and mandibular retromolar bones. This case report aims to present the management of a true iatrogenic open bite with posterior teeth in centric occlusion, occurring after mandibular setback surgery. The anterior open bite accompanied a severe class II malocclusion and increased lower anterior facial height. The patient was treated with fixed lingual appliances and mini-screws to distalize the entire maxillary arch and close the open bite. After treatment, a positive overbite and dental class I relationship was achieved. The treatment outcomes were stable at the 2-year follow-up. Lingual appliances combined with mini-screws may offer effective non-surgical management of iatrogenic open bite after orthognathic surgery. Iatrogenic open bites can develop from various causes that include surgical options such as orthognathic surgery or in patients treated with occlusal splint therapy. These may be treated with the help of skeletal anchorage options such as orthodontic mini-screws.
正颌手术后医源性开牙合是一种罕见的错牙合畸形,文献中仅报道过一例。然而,本病例报告中的开牙合并非真正的开牙合,而是由上颌第二磨牙与下颌磨牙后区骨之间的干扰导致的。本病例报告旨在介绍在下颌后缩手术后出现的、后牙处于正中咬合位的真正医源性开牙合的治疗方法。前牙开牙合伴有严重的安氏II类错牙合及面下1/3高度增加。患者接受了固定舌侧矫治器和微种植钉治疗,以使整个上颌牙弓远中移动并关闭开牙合。治疗后获得了正常覆牙合及安氏I类牙关系。在2年随访时治疗效果稳定。舌侧矫治器联合微种植钉可为正颌手术后医源性开牙合提供有效的非手术治疗方法。医源性开牙合可由多种原因引起,包括正颌手术等外科手术方式或接受牙合垫治疗的患者。这些情况可借助正畸微种植钉等骨支抗方法进行治疗。