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治疗Ⅲ类错牙合畸形的方法——叙述性综述

The Therapeutic Approaches Dealing with Malocclusion Type III-Narrative Review.

作者信息

Stojanovic Zdenka, Đorđević Nadica, Bubalo Marija, Stepovic Milos, Rancic Nemanja, Misovic Miroslav, Gardasevic Milka, Vulovic Maja, Zivanovic Macuzic Ivana, Rosic Vesna, Vunjak Nikola, Delic Simonida, Jovanovic Kristijan, Tepavcevic Melanija, Marinkovic Ivona, Rajkovic Pavlovic Zlata

机构信息

Medical Faculty of the Military Medical Academy, University of Defence, 11000 Belgrade, Serbia.

Department of Dentistry, Faculty of Medicine, University of Pristina in Kosovska Mitrovica, 38220 Kosovska Mitrovica, Serbia.

出版信息

Life (Basel). 2025 May 22;15(6):840. doi: 10.3390/life15060840.

DOI:10.3390/life15060840
PMID:40566493
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12193839/
Abstract

According to the World Health Organization, malocclusion type III is third, most important oral health problem. It may be the least prevalent malocclusion, but it is the most noticeable and challenging for orthodontic therapy. With this narrative review, we wanted to give a summation of the most current knowledge about diagnostics, different therapy options, limitations, and additional factors that can influence the therapy of class III malocclusion to help clinicians and researchers focus on the specific approaches. Therapy options were divided into the following groups: orthopedic, orthodontic, and surgical. The SNA, SNB, and ANB angles (cephalometric values) are the best ones to examine improvements in different skeletal improvements, while dentoalveolar improvements were also described, emphasizing the limitation of orthopedic therapy to change the skeletal discrepancy. Eruption-guided appliances and chin cups are more effective in early childhood, mixed dentition, during permanent teeth eruption, with no significant skeletal discrepancy. If a discrepancy exists, a face mask is the first therapy choice. The therapy of an underdeveloped maxilla can be solved with different palate expanders. Bulkiness, lack of long-term results, and duration of therapy make fixed orthodontic appliances with braces and elastic traction favorable nowadays. If the skeletal discrepancy is major, a surgical approach should be considered. One of the main limitations in articles is the combination of different therapy approaches, ages, and dentition preferred for device application, duration of therapy, and lack of information about long-term outcomes. On the other hand, the lack of original articles is noticeable, so further research should be done.

摘要

根据世界卫生组织的说法,III类错颌畸形是第三大也是最重要的口腔健康问题。它可能是最不常见的错颌畸形,但却是正畸治疗中最明显且最具挑战性的。通过这篇叙述性综述,我们想对有关III类错颌畸形诊断、不同治疗选择、局限性以及可能影响其治疗的其他因素的最新知识进行总结,以帮助临床医生和研究人员专注于特定的治疗方法。治疗选择分为以下几类:矫形治疗、正畸治疗和外科手术治疗。SNA、SNB和ANB角(头影测量值)是检查不同骨骼改善情况的最佳指标,同时也描述了牙牙槽骨的改善情况,强调了矫形治疗改变骨骼差异的局限性。萌出引导矫治器和颏兜在幼儿期、混合牙列期、恒牙萌出期间效果更佳,且骨骼差异不显著。如果存在差异,面罩是首选治疗方法。上颌发育不足的治疗可以通过不同的腭扩展器来解决。矫治器体积大、缺乏长期效果以及治疗时间长使得如今带托槽和弹性牵引的固定正畸矫治器更受青睐。如果骨骼差异较大,则应考虑手术治疗方法。文章中的主要局限性之一是不同治疗方法、年龄、矫治器应用所偏好的牙列、治疗时间以及缺乏长期疗效信息的综合情况。另一方面,原创文章的缺乏很明显,因此需要进一步开展研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/154d/12193839/8ab6800a56f7/life-15-00840-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/154d/12193839/331ab2ccb9f2/life-15-00840-g001.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/154d/12193839/259d4ad9aa25/life-15-00840-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/154d/12193839/8ab6800a56f7/life-15-00840-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/154d/12193839/331ab2ccb9f2/life-15-00840-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/154d/12193839/3f9ddf876021/life-15-00840-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/154d/12193839/03d09d0527d9/life-15-00840-g003.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/154d/12193839/8ab6800a56f7/life-15-00840-g005.jpg

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本文引用的文献

1
Comparative Analysis of Early Class III Malocclusion Treatments-A Systematic Review and Meta-Analysis.早期III类错颌畸形治疗的比较分析——一项系统评价与荟萃分析
Children (Basel). 2025 Jan 30;12(2):177. doi: 10.3390/children12020177.
2
Skeletal and dental effects of a new compliance-free appliance, the NET3 corrector, in management of skeletal Class III malocclusion compared to rapid maxillary expansion-facemask.与快速上颌扩弓-面罩相比,新型免依从性矫治器NET3矫治器在治疗骨性III类错牙合畸形中的骨骼和牙齿效应。
Angle Orthod. 2025 May 1;95(3):274-282. doi: 10.2319/121823-842.1.
3
Extraction camouflage treatment of a skeletal Class III malocclusion with severe anterior crowding by miniscrews and driftodontics in the mandibular dentition.
在下颌牙列中使用微螺钉和漂移矫正技术对伴有严重前牙拥挤的骨性III类错牙合进行拔牙掩饰治疗。
Eur J Med Res. 2025 Jan 23;30(1):48. doi: 10.1186/s40001-025-02298-9.
4
Orthognathic surgery-related condylar resorption in patients with skeletal class III malocclusion versus class III malocclusion: a systematic review and meta-analysis.骨性Ⅲ类错颌畸形患者与Ⅲ类错颌畸形患者正颌外科相关髁突吸收的系统评价与Meta分析
BMC Oral Health. 2025 Jan 15;25(1):72. doi: 10.1186/s12903-024-04921-3.
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Camouflage Orthodontic Treatment of a Severe Class III Malocclusion.重度III类错牙合畸形的掩饰性正畸治疗
Case Rep Dent. 2025 Jan 4;2025:9839448. doi: 10.1155/crid/9839448. eCollection 2025.
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Dentoalveolar characteristics in subjects with different anteroposterior relationships: a retrospective cross-sectional Cone-Beam Computed Tomography study.不同前后关系受试者的牙槽骨特征:一项回顾性横断面锥形束计算机断层扫描研究。
BMC Oral Health. 2024 Dec 31;24(1):1579. doi: 10.1186/s12903-024-05322-2.
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Diagnostics (Basel). 2024 Nov 28;14(23):2688. doi: 10.3390/diagnostics14232688.
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Early treatment of skeletal class III malocclusion with facemask therapy in Vietnam.越南采用面具疗法早期治疗骨性 III 类错颌畸形。
J Clin Pediatr Dent. 2024 Nov;48(6):187-196. doi: 10.22514/jocpd.2024.139. Epub 2024 Nov 3.