摘要
骨性Ⅱ类高角患者常表现为下颌后缩、面下1/3高度增加及垂直距离过大,面型不美观且颞下颌关节紊乱病(TMD)发生率较高。传统拔牙掩饰或单颌手术治疗往往难以在改善面型与功能之间取得平衡。近年来,以下颌逆时针旋转为核心的治疗理念受到关注,其通过下颌逆时针旋转调整[牙合]平面与下颌位置,不仅可以改善下颌后缩、优化面型,还能在一定程度上缓解关节负荷、改善TMD症状。本文从生物力学基础和病因机制、正畸治疗策略、关节功能适应及临床应用等方面系统讨论下颌逆时针旋转在骨性Ⅱ类高角病例中的作用。
Patients with skeletal ClassⅡhyperdivergent patterns often present with mandibular retrognathism,increased lower facial height,and excessive vertical dimension of occlusion,resulting in an unaesthetic facial profile and a higher incidence of temporomandibular disorder(TMD).Conventional treatments such as camouflage orthodontics with extraction or single-jaw surgery often struggle to achieve a balance between improving facial aesthetics and functional outcomes.In recent years,a treatment approach centered on counterclockwise rotation(CCR)of the mandible has gained attention.By adjusting the occlusal plane and mandibular position,this approach not only improves mandibular retrognathism and optimizes facial proportions but also helps reduce joint loading and alleviate TMD symptoms to some extent.This article systematically discusses the role of CCR in skeletal ClassⅡhyperdivergent cases from perspectives such as biomechanical foundations,orthodontic and orthognathic treatment strategies,joint functional adaptation,and clinical applications,while also offering insights into its stability and future research directions.
作者
赵志河
Zhao Zhihe(State Key Laboratory of Oral Diseases&National Center for Stomatology&National Clinical Research Center for Oral Diseases&Dept.of Orthodontics,West China Hospital of Stomatology,Sichuan University,Chengdu 610041,China)
出处
《华西口腔医学杂志》
北大核心
2026年第1期1-8,共8页
West China Journal of Stomatology
