骨性Ⅲ类错不对称拔牙矫治体会

Experience in treatment of skeletal Class Ⅲ patients with asymmetric orthodontic tooth extraction

目的探讨不对称拔牙方式矫治骨性Ⅲ类错畸形的可行性。方法骨性Ⅲ类错畸形患者1例,经临床、模型、X线片等检查,分析病因及存在的问题,制定矫治方案,使用直丝弓矫治技术,采用下颌双侧拔牙、上颌单侧不对称拔牙矫治的方法,代偿上下颌骨矢状向关系不调。结果经过25个月的治疗,患者侧貌得到改善,且未出现骨性Ⅲ类特有的凹面型,并获得了良好的前牙切导关系及平衡稳定的咬合关系。结论骨性Ⅲ类错畸形患者上颌减数需慎重,可在治疗一段时间后视上颌牙列的拥挤度、上下中线位置、面型后续变化等情况,尝试不对称拔牙的矫治方案。

Objective To investigate the feasibility of orthodontic treatment of skeletal classⅢwith asymmetric ortho-dontic tooth extraction. Methods A case of patient with skeletal class Ⅲ was examined by the clinical, model, X-ray and other examinations to analyze the causes and problems. The correct plan was made and the straight wire appliance was applied. Mandibular bilateral extraction and unilateral asymmetric tooth extraction method was used to adjust the un-coordinated sagittal relationship between the upper and lower mandible. Results After 25 months of treatment, the pa-tient＇s profile was improved. There was no skeletal ClassⅢ unique concave type profile appeared and good incisal guide and balanced occlusal relationship was obtained. Conclusion Maxillary teeth reduction of patients with skeletal ClassⅢshould be carefully used. But for some special cases, after a period of the treatment, asymmetric tooth extraction can be applied according to the upper dentition crowding, upper and lower midline and subsequent facial changes.