Mehmet Ali YAVAN, Beytullah GÜLSOY, Nihal HAMAMCI

Genç Erişkin Bir Hastada İskeletsel Sınıf III Maloklüzyonun Hızlı Üst Çene Genişletme ve Kapaklı Braket Sistemi ile Ortodontik Tedavisi – Bir Olgu Sunumu

BBu olgu sunumunun amacı, büyüme ve gelişimi henüz tamamlanmış, iskeletsel ve dental sınıf III maloklüzyona sahip genç yetişkin bir hastanın kamuflaj tedavisinin sonuçlarını sunmaktır. 13 yaşındaki kadın hasta üst köpek dişlerinin malpozisyonu şikayetiyle kliniğimize başvurmuştur. Klinik incelemede hastada, sirkümmaksiller çapraz kapanış, çift taraflı sınıf III molar ve kanin ilişki ile artmış overbite tespit edilirken, sefalometrik incelemede kafa kaidesine göre geride bir maksilla, azalmış maksillo-mandibular fark (ANB: -2,8), retrokline alt keserler ve retrüze üst dudak saptanmıştır. Hasta ve ailesi ortodontik yüz maskesi veya ortognatik cerrahi seçeneklerini kabul etmedikleri için çekimsiz kamuflaj tedavisinde karar kılınmıştır. Hastanın maksillasının genişletilerek posterior çapraz kapanışının düzeltilmesi için öncelikle hızlı üst çene genişletme (HÜG) protokolü uygulanmıştır. Genişletme cihazının uzaklaştırılması sonrası düşük torklu kapaklı braket sistemi ile sabit ortodontik tedaviye başlanmıştır. Bu tedaviyle de anterior çapraz kapanış düzeltilmiş ve üst ve alt çenedeki dişler seviyelenmiş ve hizalanmıştır. Tedaviyle alt keser açıları ideal sınırlarda tutularak, üst keser dişlerin yeterli protrüzyonu ve mandibulanın saat yönündeki rotasyonuyla sınıf I dental ve iskeletsel ilişki elde edilmiş ve üst dudakta protrüzyon gözlenmiştir. HÜG ve düşük torklu kapaklı braket sistemiyle sınıf III maloklüzyona sahip vakada iskeletsel, dental ve yumuşak dokuda belirgin iyileşmeler elde edilmiştir.

Anahtar Kelimeler:

Sınıf III maloklüzyon, Kamuflaj tedavisi, Kapaklı braket

Orthodontic Treatment of A Skeletal Class III Malocclusion in A Young Adult Patient With Rapid Maxillary Expansion and Self-Ligating Bracket System - A Case Report

The aim of this case report was to present the results of a camouflage treatment in a young adult patient with skeletal and dental Class III malocclusion. A 13-year old female patient referred to our clinic with with a chief complaint of upper canine malposition. In clinical examination, increased overbite with circummaxillary cross-bite, bilateral class III molar and canine relationships were detected. Cephalometric examination revealed a retruded maxillary complex, decreased maxillo-mandibular difference (ANB: -2.8), retroclined lower incisors, and retruded upper lip. Since the patient and her family did not accept orthodontic face mask or orthognathic surgery options, the final decision was camouflage treatment without extraction. In order to correct the posterior cross-bite, the rapid maxillary expansion (RME) protocol was applied. After the expansion device was removed, fixed orthodontic treatment was started with a low-torque self-ligating bracket system. With this treatment, the anterior cross bite was corrected, and the upper and lower teeth were leveled and aligned. Class I dental and skeletal relationships were achieved through adequate protrusion of the upper incisors and clockwise rotation of the mandible while keeping the lower incisor angles within ideal limits, and protrusion was observed in the upper lip. Significant improvements were achieved in skeletal, dental and soft tissues of the case with class III malocclusion with the RME and low torque self-ligating bracket system.

Keywords:

Class III malocclusion, Camouflage treatment, Self-ligating bracket,

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