Severe open bite due to traumatic condylar fractures treated nonsurgically with implanted miniscrew anchorage
Severe open bite due to traumatic condylar fractures treated nonsurgically with implanted miniscrew anchorage
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DOI：
10.1016/j.ajodo.2012.04.024
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发表时间：
2013-04-01
影响因子：
3
通讯作者：
Yamashiro, Takashi
中科院分区：
文献类型：
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作者：
Yanagita, Takeshi;Adachi, Rie;Yamashiro, Takashi
本病例报告说明了使用微型螺钉治疗下颌髁突骨折引起的开牙合患者。患者就诊时年龄36岁，主诉咀嚼困难。她在就诊前6个月的一场交通事故中遭受了髁突和上颌骨骨折。她有前牙开合和角度 II 类磨牙关系。她的下颌中线相对于上颌骨向右偏斜。头影测量分析显示骨骼 II 类关系。在双侧上颌颊区植入钛微螺钉。使用弹性链和微型螺钉将上颌牙列缩回并压入。经过这次治疗，获得了Angle I类磨牙关系，覆牙合变得理想，并获得了良好的面部外观。总积极正畸治疗期为33个月。治疗开颌并伴有磨牙侵入通常会导致下颌逆时针旋转；然而，在该患者中，下颌骨向前和向上移动。我们认为这种运动是由患者的髁突骨折和随后的重塑引起的。尽管存在一些复发，但我们的结果表明种植体支抗对于矫正源自髁突骨折的前牙开牙合很有用。 (Am J Orthod Dentofacial Orthop 2013;143:S137-47)
This case report illustrates the use of miniscrews to treat a patient with an open bite caused by mandibular condylar fractures. The patient was 36 years old when she visited our hospital with a chief complaint of difficulty with chewing. She had suffered condylar and maxillary bone fractures in a traffic accident 6 months before her visit. She had an anterior open bite and Angle Class II molar relationships. Her mandibular midline was deviated to the right relative to the maxilla. The cephalometric analysis showed a skeletal Class II relationship. Titanium miniscrews were implanted in the bilateral maxillary buccal areas. The maxillary dentition was retracted and intruded by using elastomeric chains and miniscrews. After this treatment, an Angle Class I molar relationship was achieved, her overjet and overbite became ideal, and a good facial appearance was obtained. The total active orthodontic treatment period was 33 months. Treating an open bite with molar intrusion often leads to counter-clockwise rotation of the mandible; however, in this patient, the mandible was moved anteriorly and upward. We believe that this movement was caused by the patient's condylar fractures and the subsequent remodeling. Although there was some relapse, our results suggest that implant anchorage is useful for correcting anterior open bites originating from condylar fractures. (Am J Orthod Dentofacial Orthop 2013;143:S137-47)