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青少年严重骨性III类错牙合畸形的掩饰性治疗,联合前方功能移位和低角型,实现有效扭矩控制

Camouflage treatment of severe skeletal class III malocclusion with effective torque control in an adolescent combined with forward functional shift and hypodivergent.

作者信息

Yu Ting, Lv Dongmei, Xu Dan, Wang Huiyue, Xiong Xin, Cheng Qian

机构信息

Department of Stomatology, The Fourth Affiliated Hospital of Southwest Medical University (TianFu Affiliated Hospital), Meishan, China.

Department of Orthodontics, The Affiliated Stomatological Hospital of Southwest Medical University, Luzhou, 646000, China.

出版信息

BMC Oral Health. 2025 May 22;25(1):762. doi: 10.1186/s12903-025-06113-z.

Abstract

Skeletal Class III malocclusion, often presenting with anterior crossbite, significantly affects patients' oral function, facial aesthetics, and psychological well-being. Here, we report the case of a 17-year-old male patient with a severe skeletal Class III malocclusion, characterized by a concave profile, anterior crossbite, pronounced curve of Spee, and functional anterior shift. The patient preferred a non-surgical approach, posing a challenge for camouflage treatment. The treatment plan involved sequential steps: initially, aligning the maxillary dentition using a mandibular bite block, followed by aligning the mandibular dentition with a maxillary bite block. During this process, uncontrolled torque of the mandibular anterior teeth was observed. To address this, an anterior root torquing spring was applied to control the torque of the lower anterior teeth. Subsequently, a flat bite plane and vertical elastics were utilized to establish proper posterior occlusion. This approach effectively eliminated the functional mandibular shift, resulting in a clockwise mandibular rotation and significant profile enhancement. Throughout treatment, periodontal health was meticulously monitored, ensuring its preservation. Post-treatment outcomes demonstrated well-aligned dentition and correction of the anterior crossbite. At the one-year follow-up, the treatment outcome remained stable.

摘要

安氏III类错牙合畸形常伴有前牙反牙合,严重影响患者的口腔功能、面部美观及心理健康。在此,我们报告一例17岁男性严重安氏III类错牙合畸形患者,其特征为面部轮廓凹陷、前牙反牙合、斯皮曲线明显及功能性前移位。患者倾向于非手术治疗方法,这给掩饰性治疗带来了挑战。治疗计划包括以下步骤:首先,使用下颌咬块排齐上颌牙列,然后使用上颌咬块排齐下颌牙列。在此过程中,观察到下颌前牙出现了不受控制的转矩。为解决这一问题,应用了一根前牙根转矩弹簧来控制下前牙的转矩。随后,使用平面导板和垂直牵引来建立合适的后牙咬合关系。这种方法有效地消除了功能性下颌移位,导致下颌顺时针旋转,面部轮廓明显改善。在整个治疗过程中,对牙周健康进行了细致监测,确保其得以维护。治疗后结果显示牙列排列整齐,前牙反牙合得以矫正。在一年的随访中,治疗效果保持稳定。

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