안면 비대칭을 동반한 골격성 II급 부정교합의 수술교정 치료

초록

This case report describes a successful surgical orthodontic treatment of a Class II malocclusion with facial asymmetry. An 18-year-old female visited our dental clinic due to proclined anterior teeth and facial asymmetry. Straight facial profile and skeletal Class II was observed. The frontal cephalometric analysis showed that the left ramus length was longer and the left ramal angle was greater than the right. After extraction of the maxillary and mandibular second premolars, dental arch was decompensated. After presurgical orthodontic treatment, bilateral sagittal split ramus osteotomy (BSSRO) was performed. Facial asymmetry was improved, but posterior open bite on the right was occurred by insufficient dental decompensation. To prevent recurrence of the mandible, a bite stop was made by bonding resin on the lingual side of the right maxillary canine. This prevented the recurrence of the mandibular rolling and yawing with the use of bilateral intermaxillary elastics. The right mandibular posterior part with open bite was segmented from the main arch wire and was extruded with intermaxillary elastic. Fast occlusal stabilization was achieved by using the rapid tooth movement after surgery. Since intermaxillary elastic was used while applying an intrusion force with a micro-implant to the left posterior region, it was possible to stabilize the mandible while prevent tooth extrusion. After treatment, facial symmetry and good occlusal relationship were achieved.

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