关键词: 特发性髁突吸收, 骨性Ⅱ类错牙合, 高角病例, 正畸正颌联合治疗, 牙合板治疗, 颞下颌关节紊乱

Abstract:

The patients with skeletal Class Ⅱ high-angle malocclusion are frequently complicated by idiopathic condylar resorption （ICR）， which may lead to temporomandibular joint （TMJ） dysfunction and dentofacial deformities. This article reports the diagnosis and treatment process of a 24-year-old female patient with skeletal Class Ⅱ high-angle malocclusion accompanied by ICR. The patient’s chief complaints were anterior open bite and TMJ pain， and was diagnosed with ICR through clinical examination and imaging. After stabilizing condylar resorption with occlusal splint therapy， combined orthodontic-orthognathic treatment was performed. The 42-month follow-up revealed： well-aligned dentition with complete closure of diastemas， significant improvement of protrusive facial profile （ANB angle reduced by 4.2°）， complete resolution of TMJ pain and clicking， and establishment of stable Class Ⅰ occlusion. Three-dimensional CT demonstrated satisfactory condylar bone remodeling and normalized joint space. Through multidisciplinary treatment， both occlusal function and facial aesthetics were significantly improved. This case demonstrates that orthodontic-orthognathic treatment should be performed after condylar stabilization in ICR patients， and occlusal splint therapy serves as an effective preoperative intervention.

Key words: Idiopathic condylar resorption, Skeletal Class Ⅱ malocclusion, High-angle case, Combined orthodontic-orthognathic treatment, Occlusal splint therapy, Temporomandibular joint disorders