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通过正畸掩饰法实现Ⅲ类错牙合的美学与功能:一例临床病例报告

Achieving Aesthetics and Function in Class III Malocclusion Through Orthodontic Camouflage: A Clinical Case Report.

作者信息

Gilani Rizwan, Kathade Anjali, Singh Shefali, Atey Aishwarya R

机构信息

Department of Orthodontics and Dentofacial Orthopedics, Sharad Pawar Dental College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.

出版信息

Cureus. 2024 Jul 21;16(7):e65063. doi: 10.7759/cureus.65063. eCollection 2024 Jul.

Abstract

Class III malocclusion is a challenging dental and skeletal condition characterized by a protrusive mandible, retrusive maxilla, or a combination of both. Treatment options include growth modification, orthodontic camouflage, and orthognathic surgery. While surgery often provides definitive results for severe cases, orthodontic camouflage is a viable alternative for managing mild to moderate skeletal discrepancies in adults. This case report illustrates the successful use of orthodontic camouflage in a 19-year-old female with skeletal and dental class III malocclusion, emphasizing nonsurgical strategies to achieve functional and aesthetic improvements. The patient presented with concerns about her bite and facial profile. Clinical examination revealed a concave profile, prominent mandible, and class III molar and canine relationships with a negative overjet. The radiographic analysis confirmed a skeletal class III relationship (ANB angle of -2°) and normal vertical growth patterns. The chosen nonsurgical treatment plan involved fixed orthodontic appliances and class III intermaxillary elastics to correct the malocclusion and improve facial aesthetics. The treatment phases included initial alignment, class III elastic application to adjust the occlusion, and detailed finishing to refine results. After 20 months, the treatment resulted in a positive overjet, class I molar and canine relationships, and improved facial aesthetics with reduced mandibular prominence. The patient expressed satisfaction with both functional and aesthetic outcomes. This case demonstrates that orthodontic camouflage can effectively manage mild to moderate class III malocclusion in non-growing patients. Successful outcomes depend on precise treatment planning, patient compliance, and regular monitoring. While surgical options remain necessary for severe cases, orthodontic camouflage provides a less invasive alternative for suitable patients, significantly improving dental function and facial aesthetics.

摘要

III类错颌畸形是一种具有挑战性的牙齿和骨骼疾病,其特征为下颌前突、上颌后缩或两者兼而有之。治疗选择包括生长改良、正畸掩饰治疗和正颌手术。虽然手术通常能为严重病例提供确切的治疗效果,但正畸掩饰治疗是治疗成人轻至中度骨骼差异的一种可行替代方法。本病例报告阐述了正畸掩饰治疗在一名患有骨骼和牙齿III类错颌畸形的19岁女性中的成功应用,强调了通过非手术策略实现功能和美观改善。患者对自己的咬合和面部轮廓表示担忧。临床检查发现面部轮廓凹陷、下颌突出,以及III类磨牙和尖牙关系伴前牙反覆盖。影像学分析证实为骨骼III类关系(ANB角为-2°)且垂直生长模式正常。所选择的非手术治疗方案包括使用固定正畸矫治器和III类颌间牵引橡皮圈来矫正错颌畸形并改善面部美观。治疗阶段包括初始排齐、应用III类牵引橡皮圈调整咬合,以及精细调整以完善治疗效果。20个月后,治疗使前牙覆盖变为正值、磨牙和尖牙呈I类关系,面部美观得到改善,下颌突出减轻。患者对功能和美观效果均表示满意。本病例表明,正畸掩饰治疗可有效治疗非生长发育期患者的轻至中度III类错颌畸形。成功的治疗效果取决于精确的治疗计划、患者的依从性和定期监测。虽然严重病例仍需要手术治疗,但正畸掩饰治疗为合适的患者提供了一种侵入性较小的替代方法,可显著改善牙齿功能和面部美观。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/84c5/11336157/37fb904b9797/cureus-0016-00000065063-i01.jpg

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