吉林大学学报（医学版）2025，Vol.51Issue(2)：508-515,8.DOI:10.13481/j.1671-587X.20250226
无托槽隐形矫治联合正颌手术治疗骨性Ⅱ类高角错(牙合)畸形患者1例报告及文献复习
Treatment of skeletal class Ⅱ high angle malocclusion patient by clear aligner therapy combined with orthognathic surgery:A case report and literature review
摘要
Abstract
Skeletal class Ⅱ malocclusion is characterized by maxillary protrusion,mandibular retrognathia,or a combination of both,and often accompanied by vertical dimensional discrepancies;treatment is complex,and combined orthodontic-orthognathic surgery is needed for the adult patients.Clear aligner therapy has gradually been applied in complex orthodontic cases.However,limited cases have been reported domestically and internationally regarding the application of clear aligner therapy combined with orthognathic surgery.This article presented a case of a patient with skeletal class Ⅱ high-angle malocclusion treated with the combined therapy and analyzed the clinical efficacy of the treatment appraoch to provide reference for the clinical practice.Extraction of impacted wisdom teeth 18,28,38,and 48,as well as orthodontic teeth 15,25,34,and 44,was performed in stages before orthodontic treatment.Clear aligner therapy was used for preoperative orthodontics.In sagittal plane,a super-complete class Ⅱ canine and molar relationship and a 13-14 mm overjet of the anterior teeth were established.The maxillary and mandibular arch morphology was matched horizontally.The orthognathic surgery included maxillary LeFort Ⅰ osteotomy,bilateral sagittal split ramus osteotomy(BSSRO)and chinplasty.Fine occlusal adjustment was conducted after operation.After treatment,the skeletal relationship between upper and lower jaw was corrected to normal;subspinale-nasion-supramental angle(ANB)was improved from 12.3° to 4.7°;the patient established the class Ⅰ canine and molar relationship,with normal overjet and overbite;root parallelism was good and there was no obvious root resorption;the facial soft tissue profile was significantly improved,and nasion-subnasale-pogonion angle(N-Sn-Pg)was improved from 143.9° to 162.8°.The curative effect was stable 1 year after operation.Clear aligner therapy can efficiently complete combined orthodontic and orthodontic surgery in the complex cases.Compared with the fixed appliance,it is more beneficial to the patients'need for beauty and the maintenance of periodontal health.关键词
正畸正颌联合治疗/骨性Ⅱ类错(牙合)畸形/无托槽隐形矫治/高角错(牙合)畸形/病例报告Key words
Combined orthodontic and orthognathic surgery/Skeletal class Ⅱ malocclusion/Clear aligner therapy/High angle malocclusion/Case report分类
医药卫生引用本文复制引用
张琦,徐晓媛,吴聿淼,张晗,胡志强,袁佳敏,崔宇琛,朱宪春..无托槽隐形矫治联合正颌手术治疗骨性Ⅱ类高角错(牙合)畸形患者1例报告及文献复习[J].吉林大学学报（医学版）,2025,51(2):508-515,8.基金项目
吉林省科技厅自然科学基金项目(YDZJ202201ZYTS057) （YDZJ202201ZYTS057）
