Orthodontische Behandlung der skelettalen Klasse-III-Malokklusion in Verbindung mit mandibulärer Laterodeviation

Zusammenfassung

Der skelettal bedingte verkehrte Überbiss (Progenie bzw. Retromaxillie) wird in Verbindung mit einer Unterkieferseitabweichung oftmals als orthognath-chirurgische Indikation angesehen. Bisher wurde die posteriore Diskrepanz (Engstand distal der ersten Molaren) nicht als Entstehungsursache der Unterkieferseitabweichung berücksichtigt. Anhand zweier dokumentierter Patientenbeispiele wird dargestellt, dass die mandibuläre Lateraldeviation (MLD) über Vorkontakte der posterioren Diskrepanz entstehen kann und dass eine rein orthodontische Behandlung des posterioren Engstands einerseits die MLD und andererseits die dabei auftretenden Kiefergelenksfehlfunktionen beseitigt, ohne auf chirurgische Interventionen zurückgreifen zu müssen.

Abstract

A skeletally induced inverse overbite (prognathia, retromaxillia) combined with mandibular lateral deviation is often considered an indication for orthognathic surgery. Up to now posterior discrepancy, i. e. crowding distal of the first molars, has not been regarded as a factor causing lateral mandibular displacement. Two case examples show that premature occlusal contacts may cause lateral mandibular deviation in posterior discrepancy dentitions. Orthodontic correction of the posterior discrepancy eliminated lateral mandibular displacement and accompanying temporomandibular joint dysfunctions without any surgical intervention.

Klasse III - Unterkieferseitabweichung - Multiloop Edgewise Archwire

Class III malocclusion - lateral mandibular deviation - multiloop edgewise archwire

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