Combined Orthodontic and Prosthetic Treatment of a Patient with Angle Class II Division 1 Malocclusion: A Case Report

Nemanja Okičić, Marko Milosavljević, M. Jovanović, Đorđe Božović, Jelena Erić
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Abstract

Abstract Skeletal class II division 1 malocclusion is primarily characterized by maxillary protrusion, mandibular retrusion or a combination of both. Treatment modalities for these patients are different depending on the age and the severity of the case. In adult patients with skeletal class II division 1, where the discrepancy is very severe, orthodontic and orthognathic surgery combined are often necessary to ensure an appropriate treatment, while prosthodontic treatment may be a challenge due to the skeletal discrepancies of the maxilla and the mandible. This clinical report presents a 45-year-old patient with a diagnosis of Angle Class II division 1 malocclusion. After clinical and radiographic observation and consultation with an orthodontist and maxillofacial surgeon, a combination of surgical and orthodontic therapy was proposed. Considering that the patient refused the surgical procedure due to fear, orthodontic therapy was carried out first, which improved the aesthetic and functional characteristics, but did not give results in increasing the vertical dimension of the occlusion. Therefore, further therapy was prosthetic, and was carried out by making all-ceramic maxillary and mandibular fixed dental prostheses; the patient was successfully rehabilitated and the anteroposterior discrepancy between the dental arches was corrected. Combined orthodontic and prosthetic treatment can be a good option in the complex treatment of patients with skeletal class II division 1 malocclusion providing functional rehabilitation of the stomatognathic system and improving facial appearance and the quality of life of the patient.
对一名角畸形 II 类 1 级患者进行正畸和修复联合治疗:病例报告
摘要 骨骼二类一分化错颌畸形主要表现为上颌前突、下颌后缩或两者兼有。这些患者的治疗方法因年龄和病情严重程度而异。对于骨骼分级为 II 类 1 级的成年患者,由于其骨骼差异非常严重,通常需要结合正畸和正颌外科手术来确保适当的治疗,而由于上颌骨和下颌骨的骨骼差异,修复治疗可能是一项挑战。本临床报告介绍了一位45岁的患者,诊断为角II类1分区错颌畸形。经过临床和放射学观察,并咨询了正畸和颌面外科医生后,医生提出了手术和正畸相结合的治疗方案。考虑到患者因恐惧而拒绝手术治疗,因此首先进行了正畸治疗,这改善了患者的美观和功能特征,但在增加咬合的垂直度方面效果不佳。因此,进一步的治疗以修复为主,通过制作全瓷上颌和下颌固定义齿来实现;该患者成功获得了康复,牙弓之间的前后不一致也得到了矫正。正畸和修复联合治疗是骨骼二类一区错颌畸形患者复杂治疗中的一个不错的选择,它能提供口颌系统的功能康复,改善患者的面部外观和生活质量。
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