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重度III类错牙合畸形的掩饰性正畸治疗

Camouflage Orthodontic Treatment of a Severe Class III Malocclusion.

作者信息

Nyakale Mandla Dominic

机构信息

Department of Orthodontics, School of Dentistry, Sefako Makgatho Health Sciences University, Pretoria, South Africa.

出版信息

Case Rep Dent. 2025 Jan 4;2025:9839448. doi: 10.1155/crid/9839448. eCollection 2025.

Abstract

Class III malocclusion remains the most challenging occlusal problem to treat due to the complexity of the interrelationships of the underlying skeletal and dental structures. Camouflage orthodontic treatment is a preferred alternative method used to manage mild to moderate Class III malocclusion in nongrowing patients. The aim of this article was to demonstrate a camouflage orthodontic treatment of a 22-year-old female patient diagnosed as having a severe skeletal Class III malocclusion characterized by a straight facial profile, reverse overjet, crowded maxillary incisors, retrognathic maxilla, prognathic mandible, and a hypodivergent facial pattern. The initial diagnosis suggested orthognathic surgery, but the patient preferred the alternative treatment. The treatment approach chosen was nonextraction camouflage orthodontic treatment combined with Class III elastics. At the end of treatment, the canines and molars were in a Class I relationship, while the incisors presented a normal overjet and overbite relationship. The maxillary and mandibular midlines corresponded with each other and with the midsagittal plane, and the smile aesthetics were improved. The facial profile was slightly improved, and the vertical face height was also slightly increased with treatment. The treatment results were maintained 15 months after treatment. It was concluded that camouflage orthodontic treatment can be used as an effective alternative method to achieve acceptable dentofacial aesthetics, functional occlusion, and stability in treating an adult patient diagnosed with severe skeletal Class III malocclusion characterized by a retrognathic maxilla, prognathic mandible, and a hypodivergent facial pattern.

摘要

由于潜在的骨骼和牙齿结构之间相互关系的复杂性,III类错颌仍然是最难治疗的咬合问题。掩饰性正畸治疗是用于治疗非生长发育期患者轻度至中度III类错颌的一种首选替代方法。本文的目的是展示对一名22岁女性患者的掩饰性正畸治疗,该患者被诊断为严重骨骼性III类错颌,其特征为直面型、反覆盖、上颌切牙拥挤、上颌后缩、下颌前突以及低角面型。初始诊断建议进行正颌手术,但患者更倾向于替代治疗。所选择的治疗方法是不拔牙掩饰性正畸治疗结合III类牵引。治疗结束时,尖牙和磨牙呈I类关系,而切牙呈现正常的覆盖和覆合关系。上颌和下颌中线相互对应且与正中矢状面一致,微笑美观度得到改善。面部轮廓略有改善,治疗后垂直面高度也略有增加。治疗结果在治疗后15个月得以维持。结论是,对于一名被诊断为严重骨骼性III类错颌、特征为上颌后缩、下颌前突以及低角面型的成年患者,掩饰性正畸治疗可作为一种有效的替代方法,以实现可接受的牙颌面美观、功能咬合和稳定性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1f47/11724728/48354a7fb618/CRID2025-9839448.001.jpg

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