Application of palatally positioned mini-screws together with the Herbst appliance for rehabilitating adult patients with skeletal types of distal dental arch relationships: a clinical case

R. Fadeev, N. D. Pirskii
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Abstract

Relevance. Utilizing the Herbst appliance for managing distal occlusal relationships in patients with completed facial growth serves as an alternative to surgico-orthodontic methods. This approach, however, extends the treatment duration and necessitates stabilization of the upper molars following removal of the appliance when moving the anterior segment of the upper dentition distally.Objective. To clinically substantiate the feasibility of combining the Herbst appliance with palatally positioned mini-screws for treating distal dental occlusal relationships in adult patients.Description of сlinical сases. Clinical photographic documentation and diagnostic modeling of facial and dentition were conducted for two patients. This was complemented by the computation and analysis of jaw CT scans and profile cephalometric radiographs. The AMORF method was employed for a quantitative evaluation of dentomaxillofacial anomalies. Hypotheses were drawn based on the employment of a 6.0 mm micro-implant at the median suture in projection with teeth 1.6-2.6, alongside the Herbst appliance, suggesting potential stability of the upper molars during the distal repositioning of the anterior segment of the upper dentition.Conclusion. The outcomes from the documented clinical cases suggest that integrating palatally positioned mini-screws with the Herbst appliance facilitates stable positioning of the upper jaw’s first molars during the distal movement of the anterior segment, attributed to the solid support provided by the mini-screw implant.
将腭侧定位微型螺钉与赫氏矫治器一起应用于远端牙弓关系骨骼类型的成年患者的康复:一个临床病例
相关性。对于面部发育完成的患者,使用赫氏矫治器处理远端咬合关系是外科正畸方法的一种替代方法。然而,这种方法会延长治疗时间,并且在向远端移动上牙列前部时,必须在移除矫治器后稳定上磨牙。临床证实将赫氏矫治器与腭侧定位微型螺钉相结合治疗成年患者远端牙齿咬合关系的可行性。对两名患者的面部和牙齿进行了临床照片记录和诊断建模。此外,还对颌骨 CT 扫描和头面部轮廓 X 光片进行了计算和分析。采用 AMORF 方法对牙颌畸形进行定量评估。根据在 1.6-2.6 颗牙齿的正中缝合处植入 6.0 毫米微型种植体,并同时使用 Herbst矫治器的推测,上部磨牙在上部牙列前段远端重新定位时可能具有稳定性。所记录的临床病例结果表明,将腭侧定位的微型螺钉与 Herbst矫治器整合在一起有助于上颌第一磨牙在前牙远端移动过程中的稳定定位,这要归功于微型螺钉种植体提供的稳固支撑。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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