正畸联合正颌治疗骨性Ⅱ类并发特发性突吸收1例报告及文献复习

打开文本图片集

[中图分类号] R783.5 [文献标志码] B

Orthodontic combined with orthognathic treatment of a Class II malocclusion patient with idiopathic condylar resorption：A case report and literature review

YUANJiamin1，WANG Songqing1²，WU Yumiao1， CUI Yuchen1，ZHANG Qi¹， ZHU Xianchun1

（1.Department of Orthodontics， Stomatology Hospital， Jilin University，Changchun l3Oo21，China; 2. Department of Orthodontics， Sixth People's Hospital ，Anyang City，Henan Province， Anyang 455000，China）

ABSTRACT The patients with skeletal Class I high-angle malocclusion are frequently complicated by idiopathic condylar resorption（ICR），which may lead to temporomandibular joint（TMJ） dysfunction and dentofacial deformities.This article reports the diagnosis and treatment process of a 24-year-old female patient with skeletal Class II high-angle malocclusion accompanied by ICR.The patient’s chief complaints were anterior open bite and TMJ pain，and was diagnosed with ICR through clinical examination and imaging.After stabilizing condylar resorption with occlusal splint therapy，combined orthodontic orthognathic treatment was performed．The 42-month follow-up revealed：well-aligned dentition with complete closure of diastemas，significant improvement of protrusive facial profile（ANB angle reduced by 4.2∘ ），complete resolution of TMJ pain and clicking，and establishment of stable Class I occlusion. Three-dimensional CT demonstrated satisfactory condylar bone remodeling and normalized joint space. Through multidisciplinary treatment，both occlusal function and facial aesthetics were significantly improved.This case demonstrates that orthodontic-orthognathic treatment should be performed after condylar stabilization in ICR patients，and ocusal splint therapy serves as an effective preoperative intervention.

KEYWORDS Idiopathic condylar resorption； Skeletal ClassI malocclusion；High-angle case; Combined orthodontic-orthognathic treatment；Occlusal splint therapy；Temporomandibular joint disorders

特发性骨突吸收（idiopathiccondylarresorption，ICR）又称为进行性髁突吸收或髁突萎缩，是一种以突表面骨皮质渐进性吸收为主要特征的罕见临床疾病，在正畸患者中的发病率为（204号 0.2%～0.7% 。（剩余11027字）