中国口腔医学继续教育杂志 ›› 2025, Vol. 28 ›› Issue (2): 108-122.DOI: 10.12337/zgkqjxjyzz.2025.02.007

• 病例报告 • 上一篇    下一篇

无托槽隐形矫治结合Andrews六要素的青少年骨性Ⅱ类拔牙病例1例

张佳忆1,2,3,#, 杨丹1,2,3,#, 张家愚1,2,3, 王云霁1,2,3, 宋锦璘1,2,3,*, 刘洋1,2,3,*   

  1. 1重庆医科大学附属口腔医院正畸科;
    2口腔疾病与生物医学重庆市重点实验室;
    3重庆市高校市级口腔生物医学工程重点实验室
  • 发布日期:2025-03-31
  • 通讯作者: *宋锦璘、刘洋,联系方式:023-88860222,电子邮箱:songjinlin@hospital.cqmu.edu.cn,yangliu@hospital.cqmu.edu.cn,通讯地址:重庆市渝北区龙溪街道松石北路426号,401147
  • 作者简介:#共同第一作者
  • 基金资助:
    重庆市教委科学技术研究计划 基于大数据的扩散模型头颅侧位片颈椎骨龄分期的研究与应用(项目编号:KJQN202400459); 重庆市口腔医学会“正雅口腔正畸临床研究科研基金项目”隐性矫正配合3D打印附件装置治疗骨性II类青少年错𬌗畸形(项目编号:CQSA-ZY2021-02); 重庆市科卫联合项目 基于多元混合模型方法的牙齿图像分割算法在数字化口腔的应用(项目编号:2023QNXM021)

TADs-Assisted Clear Aligner Orthodontic Treatment for Deep Overbite Adolescent Skeletal ClassⅡ Convex-profile with Tooth Extraction: A Case Report

Jiayi Zhang1,2,3,#, Dan Yang1,2,3,#, Jiayu Zhang1,2,3, Yunji Wang1,2,3, Jinlin Song1,2,3,*, Yang Liu1,2,3,*   

  1. 1Department of Orthodontics, Stomatological Hospital of Chongqing Medical University;
    2Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences;
    3Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, P.R. China.
  • Published:2025-03-31
  • Contact: *Jinlin Song,Yang Liu. Tel:023-88860222. Email: songjinlin@hospital.cqmu.edu.cn, yangliu@hospital.cqmu.edu.cn. Address: No.426 Songshibei Rd., Yubei District, Chongqing 401147, P.R. China.
  • About author:#These authors contibute equal to this manuscript.
  • Supported by:
    Scientific and Technological Research Program of Chongqing Municipal Education Commission(No.KJQN202400459); Chongqing Stomatological Association’s‘Zhengya’Orthodontic Clinical Research Fund Project(No.CQSA-ZY2021-02); the Chongqing Science and Health Joint Medical Research Project(No.2023QNXM021)

摘要: 目的: 本文报道1 例基于Andrews 六要素及颌骨生长发育特点的青少年骨性Ⅱ类深覆𬌗无托槽隐形矫治拔牙病例。诊治经过: 对一名骨性Ⅱ类深覆𬌗凸面型青少年患者进行了基于Andrews 六要素口颌面终末位设计,并通过拔除$\begin{array}{l|l} 4 & 4 \\ \hline 5 & 5 \end{array}$,辅以微种植体支抗(Temporary Anchorage Devices,TADs)进行无托槽隐形正畸治疗。结果: 通过治疗实现了内收前牙、调整深覆𬌗、深覆盖的目标,改善了骨性Ⅱ类错𬌗畸形与凸面型。结论: 以Andrews 六要素和青少年颌骨发育特点为导向,可实现三维目标位的精准定位;通过一次拔牙矫治和一次重启精调(45 副+35 副)方案,可完成前牙内收,后牙尖窝交错与垂直向控制,有效改善了面型。

关键词: 无托槽隐形矫治, Andrews六要素, 数字化正畸, 骨性Ⅱ类错牙合畸形, 临时支抗装置

Abstract: Objective: This case reports an adolescent patient with skeletal ClassⅡ deep overbite underwent clear aligner orthodontic treatment with tooth extraction, involving Andrews' six elements and jaw growth characteristics. Diagnosis and treatment: The patient received clear aligner orthodontic treatment supported by temporary anchorage devices (TADs), with the design of the occlusal final position based on Andrews' six elements, involving the extraction of teeth$\begin{array}{l|l} 4 & 4 \\ \hline 5 & 5 \end{array}$. Results: The treatment achieved the goals of retraction of the anterior teeth, adjustment of deep bite, and correction of deep overbite, significantly improving the skeletal ClassⅡ malocclusion and convex facial profile. Conclusions: Guided by Andrews' six elements and the developmental characteristics of adolescent jaw bones, this approach enables precise three-dimensional target positioning. Through a single extraction and orthodontic treatment followed by a refined adjustment (45 units + 35 units) plan, it achieves anterior tooth retraction, posterior tooth occlusal cusp-to-fossa interlocking, and vertical control, effectively improving facial aesthetics.

Key words: clear aligners, Andrews' six elements, digital orthodontics, skeletal ClassⅡ malocclusion, temporary anchorage devices