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骨性上颌前突伴双重咬合正畸治疗1例及文献回顾
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作者 赵转浓 刘俊峰 +1 位作者 张文忠 刘楚峰 《口腔疾病防治》 2026年第3期263-272,共10页
目的评估以正中关系(centric relation,CR)为导向联合微种植体强支抗与长牵引钩控根内收上前牙,治疗骨性上颌前突伴双重咬合患者的临床效果及稳定性,为临床提供参考。方法报道1例29岁成年女性骨性上颌前突、CR位与最大牙尖交错位(maximu... 目的评估以正中关系(centric relation,CR)为导向联合微种植体强支抗与长牵引钩控根内收上前牙,治疗骨性上颌前突伴双重咬合患者的临床效果及稳定性,为临床提供参考。方法报道1例29岁成年女性骨性上颌前突、CR位与最大牙尖交错位(maximum intercuspation position,MIP)不调的无症状双重咬合病例。首先通过临床手法和CBCT检查识别和获取CR位,采用玻璃离子咬合印记和肌功能训练辅助稳定CR位,然后通过上颌微种植体联合长牵引钩内收上前牙改善骨性上颌前突,最终在CR位上建立新的牙尖交错咬合关系并维持长期稳定。结合文献回顾以阐释治疗逻辑与关键环节。结果患者治疗后在CR位建立了协调、稳定的功能性咬合,患者颞下颌关节无不适,髁突与关节窝关系协调,上前牙实现了控根内收,侧貌凸度显著改善。治疗后3年随访,CR位咬合关系与髁突位置保持稳定。文献复习提示:对CR-MIP不调患者,优先识别与稳定CR位是治疗成败的关键;微种植体可有效实现上前牙内收并改善侧貌。结论对于骨性上颌前突伴双重咬合患者,采取“先行确立CR位+微种植体强支抗控根内收”的策略,可同步改善牙颌系统功能与面型,且具有良好的中长期稳定性。 展开更多
关键词 骨性上颌前突 双重咬合 正中关系 最大牙尖交错位 颞下颌关节 髁突移位 微种植体支抗 牵引钩 控根内收 上颌前牙
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Hybrid treatment of varied orthodontic appliances for a patient with skeletal class II and temporomandibular joint disorders:A case report and review of literature 被引量:2
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作者 Tong Lu Li Mei +2 位作者 Bao-Chao Li Zi-Wei Huang Huang Li 《World Journal of Clinical Cases》 SCIE 2024年第2期431-442,共12页
BACKGROUND The relation between orthodontic treatment and temporomandibular disorders(TMDs)is under debate;the management of TMD during orthodontic treatment has always been a challenge.If TMD symptoms occur during or... BACKGROUND The relation between orthodontic treatment and temporomandibular disorders(TMDs)is under debate;the management of TMD during orthodontic treatment has always been a challenge.If TMD symptoms occur during orthodontic treatment,an immediate pause of orthodontic adjustments is recommended;the treatment can resume when the symptoms are managed and stabilized.CASE SUMMARY This case report presents a patient(26-year-old,female)with angle class I,skeletal class II and TMDs.The treatment was a hybrid of clear aligners,fixed appliances and temporary anchorage devices(TADs).After 3 mo resting and treatment on her TMD,the patient’s TMD symptom alleviated,but her anterior occlusion displayed deep overbite.Therefore,the fixed appliances with TAD were used to correct the anterior deep-bite and level maxillary and mandibular deep curves.After the levelling,the patient showed dual bite with centric relation and maximum intercuspation discrepancy on her occlusion.After careful examination of temporomandibular joints(TMJ)position,the stable bite splint and Invisible Mandibular Advancement appliance were used to reconstruct her occlusion.Eventually,the improved facial appearance and relatively stable occlusion were achieved.The 1-year follow-up records showed there was no obvious change in TMJ morphology,and her occlusion was stable.CONCLUSION TMD screening and monitoring is of great clinical importance in the TMD susceptible patients.Hybrid treatment with clear aligners and fixed appliances and TADs is an effective treatment modality for the complex cases. 展开更多
关键词 Temporomandibular disorder Skeletal class II Deep overbite dual bite Invisible mandibular advancement appliance Case report
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