Mao Kaisheng, Cao Lei, Pang Zhiling, Xie Tian, Zhang Wenjuan, Jia Zhiyu, Xiao Tiepeng
Department of Orthodontics, The Second Hospital of Hebei Medical University, Heping West Road No. 215, Shijiazhuang, China.
Department of Stomatology, The Third People's Hospital of Longgang District Shenzhen, Songbai Road No. 278, Shenzhen, China.
BMC Oral Health. 2025 Apr 13;25(1):562. doi: 10.1186/s12903-025-05963-x.
Treatment for Angle's Class II division 1 involves both extraction and non-extraction orthodontic therapy. Managing Class II division 1 malocclusion accompanied by maxillary anterior tooth impaction and anterior crowding in mixed dentition poses a therapeutic dilemma. Premolar extraction may face traction failure in the impacted tooth, resulting in excessive tooth loss, while extracting impacted teeth may compromise occlusion and anterior aesthetics, necessitating future restoration. Molar distalization as a non-extraction approach often face challenges in providing sufficient space for aligning impacted teeth and simultaneously retracting proclined anterior teeth and improving the facial profile. This study describes a non-extraction orthodontic treatment plan for Class II division 1 malocclusion accompanied by maxillary anterior tooth impaction and anterior crowding in mixed dentition.
An 11-year-old girl was diagnosed with Class II division 1 malocclusion and impaction of the maxillary right lateral incisor caused by an odontoma. A non-extraction treatment plan was implemented, involving first the distalization of the maxillary molars and utilization of the leeway space to create an eruption space, followed by surgical exposure and orthodontic traction, and finally, anterior teeth retraction and mandibular advancement guided by Class II elastics. After 39 months, the impacted maxillary right lateral incisor was successfully aligned, achieving Class I molar and canine relationship with a normal overbite and overjet and an improved facial profile.
Molar distalization and use of the leeway space can avoid the need for tooth extraction during orthodontic treatment. Molar distalization and use of the leeway space can provide sufficient space to correct Class II molar relationship, align impacted teeth, and retract the maxillary anterior teeth. Retraction of the maxillary anterior tooth and guidance for mandibular advancement can improve the lateral facial profile.
安氏II类1分类错牙合的治疗包括拔牙和不拔牙正畸治疗。在混合牙列期处理伴有上颌前牙埋伏阻生和牙列拥挤的安氏II类1分类错牙合是一个治疗难题。拔除前磨牙可能会导致埋伏阻生牙牵引失败，造成过多的牙齿缺失，而拔除埋伏阻生牙可能会影响咬合和前牙美观，需要后期修复。作为一种不拔牙方法，磨牙远移在为排齐埋伏阻生牙提供足够间隙、同时内收前倾的前牙以及改善面部轮廓方面常常面临挑战。本研究描述了一种针对混合牙列期伴有上颌前牙埋伏阻生和牙列拥挤的安氏II类1分类错牙合的不拔牙正畸治疗方案。
一名11岁女孩被诊断为安氏II类1分类错牙合，上颌右侧侧切牙因牙瘤而埋伏阻生。实施了不拔牙治疗方案，首先进行上颌磨牙远移并利用替牙间隙创造萌出间隙，随后进行外科开窗和正畸牵引，最后，使用II类牵引引导前牙内收和下颌前伸。39个月后，上颌右侧埋伏阻生侧切牙成功排齐，达到磨牙和尖牙I类关系，覆盖和覆牙合正常，面部轮廓得到改善。
磨牙远移和利用替牙间隙可避免正畸治疗中拔牙的需要。磨牙远移和利用替牙间隙可为纠正II类磨牙关系、排齐埋伏阻生牙以及内收上颌前牙提供足够的间隙。上颌前牙的内收和下颌前伸引导可改善侧面面部轮廓。
