骨性Ⅱ类错[牙合]非对称拔牙掩饰性正畸治疗一例

Camouflage orthodontic treatment with asymmetric tooth extraction for a skeletal Class Ⅱmalocclusion patient

患者,女,初诊时21周岁,主诉为上牙前突。正面观左侧软组织较丰满,闭唇紧张,侧面观凸面型,颏肌紧张;口内见36残根,46大面积龋补,16、26伸长,38、48未完全萌出,双侧尖磨牙远中关系。X线测量分析该患者属于骨性Ⅱ类错[牙合]畸形,上颌前突,下颌后缩。该病例矫治策略为拔除14、24、36、46。采用Damon Q自锁托槽排齐整平上、下牙列,上颌植入2枚种植钉,以进行上颌前牙的内收和磨牙垂直向控制。目标为建立磨牙远中关系及前牙正常覆牙合覆盖,促使下颌骨逆旋,最大程度改善面型。整个疗程约为28个月,治疗结束后患者咬合关系良好,面型改善较大。

The female patient was 21 years old at the time of initial diagnosis,complaining of protrusion of the upper anterior teeth.The soft tissue on the left side is plump,the lip is tense from the front view,and the lateral view shows that the face shape is convex,the mental muscle is tense;there were residual roots of 36,extensive caries filling of 46,elongation of 16 and 26,incomplete eruption of 38 and 48,distally relation of bilateral molars.X⁃ray analysis showed that the patient was skeletal ClassⅡwith maxillary protrusion and mandibular retraction.The treatment strategy for this case was extacting 14,24,36,46.Damon Q self⁃locking brackets were used to straighten the upper and lower teeth,and two screws were implanted in the upper jaw to control the adduction of the maxillary anterior teeth and the vertical direction of the molars.The objective is to establish the ClassⅡmolar relationship between the molars and the normal overbite and overjet of the anterior teeth,promote the inverse rotation of the mandible,and improve the facial shape to the greatest extent.The whole course of treatment lasted about 28 months.After the treatment,the occlusal relationship was normal and the facial shape improved greatly.