中国口腔医学继续教育杂志 ›› 2024, Vol. 27 ›› Issue (6): 494-503.DOI: 10.12337/zgkqjxjyzz.2024.06.005

• 病例报告 • 上一篇    下一篇

青少年骨性Ⅲ类伴偏颌矫治1例

周升梅1,2, 王兵1,*   

  1. 1山东大学齐鲁医学院口腔医学院·口腔医院口腔正畸科;
    2山东省泰安市中心医院(青岛大学附属泰安市中心医院、泰山医养中心)口腔修复与正畸科
  • 出版日期:2024-11-30 发布日期:2025-06-06
  • 通讯作者: *王兵,联系方式:0531-88382069,电子邮箱:bing.wang@sdu.edu.cn,通讯地址:山东省济南市历下区文化西路44-1,250012

Orthodontic Treatment of Skeletal Class III Malocclusion with Lateral Deviation in an Adolescent: A Case Report

Shengmei Zhou1,2, Bing Wang1,*   

  1. 1Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University, Jinan, Shandong Province, P.R. China;
    2Department of Prosthodontics and Orthodontics, Tai’an Central Hospital in Shandong Province, Tai’an Central Hospital Affiliated to Qingdao University, Taishan Healthcare Center, Tai’an, Shandong Province, P.R. China
  • Online:2024-11-30 Published:2025-06-06
  • Contact: Bing Wang. Tel: 0531-88382069. Email: bing.wang@sdu.edu.cn. Address: 44-1 West Wenhua Road, Lixia District, Jinan 250012, Shandong Province, P.R. China.

摘要: 目的:本文报道1例采用微种植钉辅助上颌骨性扩弓器及前方牵引技术并配合微种植体支抗远中移动下颌牙列,掩饰性矫治青少年重度骨性Ⅲ类错𬌗畸形伴偏颌的患者。诊治经过:患者拒绝正畸-正颌联合治疗,遂进行正畸掩饰性治疗,分别通过上颌骨性扩弓器改善患者上颌骨横向不足,解除后牙颊倾,建立后牙覆盖,配合前方牵引促进上颌发育,使下颌后下旋转,配合微种植体支抗远中移动下颌牙列解除反𬌗,建立良好咬合关系。结果: 治疗后尖牙、磨牙关系基本中性,上、下中线基本一致,牙根平行度好,患者及家属对矫治效果满意。结论: 在严格把控掩饰性治疗适应证的情况下,可以通过扩弓及前方牵引纠正上颌骨横向及矢状向的发育不足,并配合远中移动下颌牙列解除反𬌗,建立中性尖磨牙关系,改善患者功能和美观,取得较好临床效果。

关键词: 骨性Ⅲ类, 上颌骨性扩弓, 前方牵引, 上颌骨横向发育不足, 微种植钉, 正畸掩饰性治疗

Abstract: Objective: This case report described the orthodontic camouflage treatment of a severe skeletal Class III malocclusion with asymmetry in a teenager using miniscrew assisted maxillary skeletal expander (MSE) and maxillary protraction with a facemask, along with micro-implant assisted mandibular full-arch distalization. Diagnosis and Treatment: The patient refused combined orthodontic-orthognathic treatment, leading to the decision to proceed with orthodontic camouflage treatment. The MSE was utilized to address the transverse deficiency of the maxilla, correct buccal tilting of the posterior teeth, and establish posterior occlusal coverage. Facemask protraction was used to promote maxillary development, meanwhile leading to posterior and downward rotation of the mandible. Micro-implant anchorage was employed to distalize the mandibular dentition, correct the crossbite and midline, and establish proper occlusion. Results: Post-treatment, the patient achieved Class I canine and molar relationships, with the upper and lower midlines nearly coinciding. The root parallelism was good, and both the patient and their family were satisfied with the treatment outcome. Conclusions: By strictly adhering to the indications of camouflage treatment, it is possible to correct maxillary transverse and sagittal deficiencies through arch expansion and forward traction, while retracting the mandibular dentition to resolve the crossbite, thereby establishing a neutral molar relationship. This approach improves both function and aesthetics for the patient, with confirmed clinical effectiveness.

Key words: skeletal classⅢ malocclusion, maxillary skeletal expansion, maxillary protraction, maxillary transverse deficiency, miniscrew, orthodontic camouflage treatment