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Informationen aus Orthodontie & Kieferorthopädie 2012; 44(03): 207-216
DOI: 10.1055/s-0032-1323673
Fallbericht

Chirurgische Korrektur der Unterkiefer-Rücklage – Differenzialdiagnostische Aspekte anhand eines Fallbeispiels

Surgical Correction of Retroposition of the Mandible – Alternative Treatment Options and Case Presentation
J. Hourfar
1   Kieferorthopädische Fachpraxis, Reinheim
,
B. Ludwig
2   Kieferorthopädische Fachpraxis, Traben-Trarbach
3   Klinik für Kieferorthopädie, Universitätsklinikum des Saarlandes, Homburg/Saar
,
B. Glasl
2   Kieferorthopädische Fachpraxis, Traben-Trarbach
,
G. Kinzinger
3   Klinik für Kieferorthopädie, Universitätsklinikum des Saarlandes, Homburg/Saar
,
J. Lisson
3   Klinik für Kieferorthopädie, Universitätsklinikum des Saarlandes, Homburg/Saar
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Zusammenfassung

Die chirurgische Korrektur der Unterkiefer-Rücklage nach prächirurgischer kieferorthopädischer Behandlung stellt – insbesondere bei erwachsenen Patienten – eine Therapieoption dar. Im vorliegenden Fallbericht wird die kombiniert kie­ferorthopädisch-kieferchirurgische Behandlung einer 22-jährigen kaukasischen Patientin mit Klasse-II-Dysgnathie bei ausgeprägtem Unterkiefer-Engstand präsentiert. Hierbei werden alternative Behandlungsoptionen diskutiert, wie die:

(1) Extraktion aller ersten Prämolaren,

(2) Ausformung der Zahnbögen und approximale Schmelzreduktion (ASR) in beiden Kiefern und konsekutiver Einsatz eines Fixed Functionals,

(3) Prämolarenextraktion nur im Unterkiefer mit Auflösung des Engstandes gefolgt von Fixed Functional (z. B. Herbst)-Behandlung (=Dekompensation der Klasse II ohne nachfolgende orthognathe Chirurgie),

(4) Prämolarenextraktion nur im Unterkiefer mit Auflösung des Engstandes gefolgt von chirurgischer Lagekorrektur der Mandibula (=Dekompensation der Klasse II mit nachfolgender orthognather Chirurgie) und

(5) Ausformung beider Zahnbögen in Verbindung mit deutlicher approximaler Schmelzreduktion (ASR) im Unterkiefer und konsekutiver chirurgischer Lagekorrektur der Mandibula.

Abstract

The surgical correction of a retroposition of the mandible following presurgical orthodontic therapy is a treatment modality to be considered particularly in adult patients. The case report presents a 22-year-old female caucasian patient with a class-II-malocclusion presenting severe crowding in the mandibular arch who underwent orthodontic treatment followed by mandibular advancement surgery. Alternative treatment options are discussed:

(1) Extraction of maxillary and mandibular first premolars,

(2) alignment of maxillary and mandibular arch, interproximal reduction (IPR) followed by fixed functional therapy,

(3) premolar extraction only in the mandibular arch, relief of crowding followed by fixed functional (e. g. Herbst) therapy (=decompensation of class-II-malocclusion without orthognathic surgery),

(4) premolar extraction only in the mandibular arch, relief of crowding followed by fixed function­al (e. g. Herbst) therapy (=decompensation of class-II-malocclusion followed by orthognathic sur­gery), and

(5) alignment of maxillary and mandibular arch, heavy interproximal reduction (IPR) in the mandibular arch followed by orthognathic surgery.

Schlüsselwörter

Erwachsenenbehandlung - orthognathe Chirurgie - chirurgische Unterkiefervorverlagerung - Unterkiefervorverlagerung - Angle Klasse II

Key wods

adult treatment - orthognathic surgery - mandibular advancement surgery - mandibular advancement - angle class II


Publication History

Article published online:
18 October 2012

© Georg Thieme Verlag KG
Stuttgart · New York

 

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