垂直向控制在矫正成人骨性Ⅱ类高角错(牙合)畸形应用中的研究进展  

Vertical control appliance in treatment of skeletal Class Ⅱ hyperdivergent adult patients: review of the literature

作　　者：瞿然奕 汪席均 江凌勇[1] QU Ran-yi;WANG Xi-jun;JIANG Ling-yong(Department of Oral and Craniomaxillofacial Surgery,Shanghai Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine,College of Stomatology,Shanghai Jiao Tong University,National Center for Stomatology,National Clinical Research Center for Oral Diseases,Shanghai Key Laboratory of Stomatology,Shanghai 200011,China)

机构地区：[1]上海交通大学医学院附属第九人民医院口腔颅颌面科,上海交通大学口腔医学院,国家口腔医学中心,国家口腔疾病临床医学研究中心,上海市口腔医学重点实验室,上海200011

出　　处：《中国口腔颌面外科杂志》2021年第3期284-288,共5页China Journal of Oral and Maxillofacial Surgery

基　　金：上海市优秀学术/技术带头人计划(20XD1422300);上海市“医苑新星”青年医学人才培养资助计划-杰出青年医学人才项目(HWJRS2019-72);上海申康医院发展中心临床创新三年行动计划资助(SHDC2020CR4084);上海交通大学医学院附属第九人民医院临床研究推助计划(临+计划)(JYLJ201807)。

摘　　要：颌骨与牙包含三个维度:矢状向、横向和垂直向,以往临床上错[牙合]畸形的矫治常聚焦于前突或后缩问题,而易忽略垂直向问题。垂直向问题往往对矢状向产生影响,如垂直向发育过度患者多呈现高角骨面型,易引起下颌骨顺时针旋转,形成骨性Ⅱ类错[牙合]畸形。早期由于相应的矫正手段有限,正颌手术一直是骨性Ⅱ类高角面型患者的首选治疗方式。随着种植支抗的出现及应用,使用微钛板和(或)微螺钉种植体可以提高单纯正畸治疗的垂直向控制效果,减小了部分轻、中度垂直向发育过度患者的治疗风险和创伤。本文旨在回顾近年关于正畸代偿及正颌-正畸联合治疗矫正成人骨性Ⅱ类高角病例的研究,从不同方式的控制效果、稳定性分析以及临界病例的治疗方式等方面,对应用垂直向控制纠正骨性Ⅱ类高角错(牙合)畸形的研究进展进行综述,为临床诊疗和相关研究提供一定的思路和依据。The treatment of malocclusion usually directs at protrusion and retrusion. However, both jaw bones and teeth contain three dimensions: sagittal, lateral and vertical direction. Vertical discordance is often be overlooked, and it can al-so affect sagittal direction. Most vertical excess patients present hyperdivergent facial skeletal type. Vertical excess can al-so lead to counterclockwise rotation of the mandible, which may cause skeletal Class Ⅱ deformation. In the early years,orthodontic treatments were quite limited, orthognathic surgery was the most common solution for hyperdivergent patients.With the appearance and application of implant anchorage, mini-titanium plates or miniscrews may improve the effect of orthodontic treatments as well as reduce the risk and trauma of some patients with mild to moderate vertical excess. This article aimed to review the recent researches about the application of vertical control in skeletal Class Ⅱ hyperdivergent patients by camouflaged orthodontic treatment or orthognathic surgery with orthodontic treatment, and summarize the effect,stability analysis and therapeutic strategy of borderline cases, in order to provide new insights into clinical diagnosis and treatments, as well as related researches.

关 键 词：垂直向控制 骨性Ⅱ类高角 正畸代偿治疗 正颌手术 种植支抗 

分 类 号：R783.5[医药卫生—口腔医学]