中国口腔医学继续教育杂志 ›› 2024, Vol. 27 ›› Issue (6): 457-467.DOI: 10.12337/zgkqjxjyzz.2024.06.002

• 病例报告 • 上一篇    下一篇

无托槽隐形矫治正畸-正颌联合治疗骨性Ⅲ类伴偏颌1例

赵婷婷1,2,3, 杨学文1,4, 花放1,2,5,*, 贺红1,2,3,*   

  1. 1口颌系统重建与再生全国重点实验室,口腔生物医学教育部重点实验室,口腔医学湖北省重点实验室,武汉大学口腔医学院;
    2湖北省儿童牙颌面畸形临床医学研究中心;
    3武汉大学口腔医院口腔正畸一科;
    4武汉大学口腔医院正颌与唇腭裂外科;
    5武汉大学口腔医院光谷院区正畸与儿童口腔中心
  • 出版日期:2024-11-30 发布日期:2025-06-06
  • 通讯作者: *花放,联系方式:027-87686226,电子邮箱:huafang@whu.eud.cn,通讯地址:湖北省武汉市洪山区珞喻路237号,430079;贺红,联系方式:027-87686226,电子邮箱:drhehong@whu.edu.cn,通讯地址:湖北省武汉市洪山区珞喻路237号,430079
  • 基金资助:
    武汉大学口腔医学院课程思政专项经费项目(项目编号:24KCSZ14)

Combined Orthodontic-orthognathic Management of A Patient with Skeletal Class III Malocclusion and Mandibular Lateral Deformity Using Clear Aligners: A Case Report

Tingting Zhao1,2,3, Xuewen Yang1,4, Fang Hua1,2,5,*, Hong He1,2,3,*   

  1. 1State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University;
    2Hubei Provincial Clinical Research Center for Dentofacial Deformities in Children, School & Hospital of Stomatology, Wuhan University, Wuhan, P.R. China;
    3Department of Orthodontics Division 1, School & Hospital of Stomatology, Wuhan University;
    4Department of Orthognathic & Cleft Lip and Palate Plastic Surgery, School & Hospital of Stomatology, Wuhan University, Wuhan, China;
    5Center for Orthodontics and Pediatric Dentistry at Optics Valley Branch, School & Hospital of Stomatology, Wuhan University, Wuhan, China
  • Online:2024-11-30 Published:2025-06-06
  • Contact: Fang Hua. Tel: 027-87686226. Email: huafang@whu.eud.cn. Address: No. 237 Luoyu Road, Hongshan District, Wuhan 430079. Hubei Province, P.R. China; Hong He. Tel: 027-87686226. Email: drhehong@whu.edu.cn. Address: No. 237 Luoyu Road, Hongshan District, Wuhan 430079. Hubei Province, P.R. China.
  • Supported by:
    Wuhan University School of Stomatology Course Ideology and Politics Project (No.24KCSZ14)

摘要: 目的:本病例报道1例采用无托槽隐形矫治联合正颌手术治疗骨性Ⅲ类伴下颌偏斜的成年病例。诊治经过:经过治疗前资料分析与方案设计,与患者商量治疗方案,选择正畸-正颌联合治疗,正畸采用隐形矫治。术前正畸拔除$\begin{array}{l|l}65 & 58 \\ \hline 6 & 8 \end{array}$,上颌前牙内收去代偿,近移$\left. \frac{87}{87} \right|$代替$\left. \frac{76}{76} \right|$;正颌术式采用上颌Lefort Ⅰ型截骨术+ 双侧下颌骨矢状劈开截骨术;术后正畸针对前牙深覆𬌗、下颌中线偏斜及后牙咬合进一步调整。结果: 患者治疗结束后侧貌为直面型,面部偏斜得到纠正,前牙覆𬌗覆盖正常,牙齿排列整齐,双侧尖牙、磨牙达到中性关系,上下中线与面中线对齐。结论: 无托槽隐形矫治联合正颌手术可有效治疗骨性Ⅲ类伴下颌偏斜患者。

关键词: 无托槽隐形矫治, 正畸-正颌联合治疗, 骨性Ⅲ类错牙合畸形, 下颌偏斜, 术前正畸

Abstract: Objective: An adult case of skeletal ClassⅢ with mandibular deviation was treated by invisible orthodontic combined with orthognathic surgery. Diagnosis and Treatment: The patient received combined invisible orthodontic and orthognathic treatment after a clear diagnosis and the patient’s informed consent. In the preoperative orthodontic stage, $\begin{array}{l|l}65 & 58 \\ \hline 6 & 8 \end{array}$ extraction was performed. The extraction space was used for decompensation of maxillary anterior teeth, and using$\left. \frac{87}{87} \right|$ to replace$\left. \frac{76}{76} \right|$. The orthognathic operation was performed with maxillary LefortⅠosteotomy and bilateral mandibular sagittal split osteotomy. After operation, orthodontics further adjusted for the anterior deep overbite, mandibular midline deviation and posterior occlusion. Results: At the end of treatment, the patient’s profile was straight, the facial deviation was corrected, overbite and overjet were normal, the teeth were arranged neatly, the bilateral canine and molar were both neutral, and the upper and lower midline was aligned with the midline of the face. Conclusions: Clear aligner combined with orthognathic surgery can effectively treat the patients with skeletal Class Ⅲ with mandibular deviation.

Key words: clear aligner, orthodontic-orthognathic combined treatment, skeletal classⅢ malocclusion;, deviation deformity of mandible, preoperative orthodontics