Meikle M C
Am J Orthod. 1980 Feb;77(2):184-97. doi: 10.1016/0002-9416(80)90006-8.
In recent years it has become apparent that there are limitations to the amount of tooth movement that can be accomplished by alveolar remodeling. Retraction of the maxillary incisor teeth should therefore be avoided during overjet correction if penetration of the palatal alveolar cortex is a probability. Since the Class II, Division 1 phenotype is characterized by abnormalities in both dentoalveolar process and maxillomandibular reactions, trying to compensate for the skeletal discrepancy through alveolar remodeling alone does not have logic on its side. Indeed, treatment philosophies based entirely on a concept of alveolar remodeling cannot be justified on biologic grounds. The most reliable method of avoiding destruction of the palatal alveolar cortex during overjet correction is by means of headgear mechanics designed to produce clinically significant skeletal remodeling. This holds as a general principle, even where extractions are an essential part of the treatment program. Furthermore, because the facial skeleton responds to mechanical deformation more readily in the growing person, the policy adopted by many orthodontists of deferring treatment until the permanent teeth have erupted has little to recommend it.
近年来，很明显，通过牙槽骨改建所能实现的牙齿移动量是有限的。因此，如果有可能穿透腭侧牙槽骨皮质，在纠正前牙深覆盖时应避免上颌切牙的后移。由于安氏II类1分类错畸形的表型特征是牙槽突和上下颌反应均异常，试图仅通过牙槽骨改建来补偿骨骼差异是不合理的。事实上，完全基于牙槽骨改建概念的治疗理念在生物学上是站不住脚的。在纠正前牙深覆盖时，避免腭侧牙槽骨皮质破坏的最可靠方法是采用头帽矫治器力学，以产生具有临床意义的骨骼改建。这是一个普遍原则，即使拔牙是治疗计划的重要组成部分。此外，由于面部骨骼在生长发育的个体中对机械变形的反应更敏感，许多正畸医生采用的推迟治疗直到恒牙萌出的策略几乎没有可取之处。
