Behandlung der Klasse-III-Dysgnathie mit Erweiterung und Vorverlagerung des Oberkiefers

P. K. Turley

doi:10.1055/s-2008-1004771

Informationen aus Orthodontie & Kieferorthopädie, Table of Contents

Informationen aus Orthodontie & Kieferorthopädie 2008; 40(1): 83-93
DOI: 10.1055/s-2008-1004771

Übersichtsartikel

Behandlung der Klasse-III-Dysgnathie mit Erweiterung und Vorverlagerung des Oberkiefers[1]

Treatment of the Class III Malocclusion with Maxillary Expansion and ProtractionP. K. Turley¹

¹Sections of Orthodontics and Pediatric Dentistry, School of Dentistry, University of California, USA

Abstract

Zusammenfassung

Obwohl die frühe kieferorthopädische Behandlung in den letzten Jahren einer kritischen Prüfung unterzogen wurde, ist die Notwendigkeit einer frühen Diagnose und Therapie der skelettalen Klasse III allgemein anerkannt. Die meisten Klasse-III-Patienten entwickeln einen retrudierten Oberkiefer mit einem normalen bis negativen Overbite und sind somit ideal geeignet für die kombinierte Behandlung mit einer Expansionsapparatur und einer Protraktionsmaske. Zu der Vorverlagerung der Maxilla bewirkt die Therapie mittels Gesichtsmaske eine Counterclockwise-Rotation des Oberkiefers und eine Clockwise-Rotation des Unterkiefers mit dem Ergebnis, dass die untere Gesichtshöhe ansteigt und das Profil konvexer erscheint. Die frühe Behandlung ist verbunden mit einer besseren Mitarbeit des Patienten und wahrscheinlich mit einem besseren orthopädischen Ergebnis; allerdings kann die Behandlung im Wechselgebiss oder im bleibenden Gebiss ebenfalls günstige Resultate liefern. Eine Überkorrektur ist empfehlenswert, da behandelte Patienten nach Behandlungsende ähnlich wie die unbehandelten Klasse-III-Patienten wachsen. Eine Behandlung über einen kurzen Zeitraum (2-3 Jahre) führt zu guter Stabilität, bei wenigen Patienten ist jedoch noch eine anschließende Therapie mittels Gesichtsmaske nötig.

Abstract

Although some early orthodontic procedures have come under scrutiny in recent years, the need for early identification and treatment of the skeletal Class III malocclusion has become even more universally accepted. Most Class III patients display a retruded maxilla with a normal to deep overbite and are ideally suited for treatment with maxillary expansion and protraction. In addition to maxillary advancement, facemask therapy rotates the maxilla in a counterclockwise direction, and the mandible in a clockwise direction, which results in an increase in lower face height and a profile that is more convex. Early intervention is associated with better patient compliance and possibly a better orthopedic response; however, treatment in the mixed or permanent dentition can produce favorable results. Overcorrection is recommended because treated patients grow similarly to untreated Class III patients after treatment. Treatment in the short term (2-3 years) shows good stability with a minority of patients requiring later facemask therapy.

Schlüsselwörter

Klasse-III-Dysgnathie - Gaumennahterweiterung - Gesichtsmaske

Key words

Class III malocclusion - rapid maxillary expansion - face mask

Full Text

References

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1 Der Artikel erschien erstmals in der Zeitschrift: Semin Orthod 2007; 13: 143-157. Der Abdruck erfolgt mit freundlicher Genehmigung.

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