单颌拔牙矫治Ⅲ°开并发舌体肥大1例报告及文献复习

doi:10.13481/j.1671-587X.20260125

摘要/Abstract

摘要：

开畸形作为临床常见的错畸形，其治疗过程复杂且复发率高，是正畸治疗的难点之一，本文作者报道1例青少年Ⅲ°开患者的诊疗经过，旨在为临床医生治疗该类疾病提供参考。患者，男性，13岁，因“牙不齐，前牙咬不上”就诊，寻求矫治以改善咬合功能和面部形态。患者临床表现为前牙Ⅲ°开、上颌Ⅲ°拥挤和舌体肥大，诊断为安氏Ⅱ类错畸形、毛氏Ⅳ²+Ⅰ¹+Ⅴ错畸形。通过上颌单颌拔牙配合舌栏的矫治方法取得了较为满意的治疗效果。矫治结束后，患者的开得到了明显改善，上下颌牙齿排列整齐，达到了尖窝交错的咬合关系。在开畸形的治疗中，应尽早纠正不良习惯，利用患者生长发育潜力、后牙的楔形效应以及前牙的钟摆效应纠正开。

关键词: 单颌拔牙, 开, 舌体肥大, 不良舌习惯, 正畸治疗, 病例报告

Abstract:

Open bite malocclusion， as a clinically common type of malocclusion， presents complex treatment processes and a high relapse rate， making it one of the challenges in orthodontic treatment. The author of this article reported the diagnosis and treatment process of a teenage patient with a grade Ⅲ open bite to provide reference for the clinicians in managing such conditions. The patient， a 13-year-old male， sought treatment for “misaligned teeth and inability to bite with front teeth” to improve occlusal function and facial appearance. The clinical manifestations included a grade Ⅲ anterior open bite， grade Ⅲ maxillary crowding， and macroglossia. The diagnosis was Angle Class Ⅱ malocclusion and Mao’s ClassⅣ²+Ⅰ¹+Ⅴ malocclusion. A satisfactory treatment outcome was achieved through maxillary single-jaw extraction combined with the use of a lingual arch. After treatment， the patient’s open bite was significantly improved， with well-aligned upper and lower teeth and an intercuspal occlusion relationship. In the treatment of open bite malocclusion， it is essential to correct bad habits as early as possible， leveraging the patient’s growth potential， the wedge effect of posterior teeth， and the pendulum effect of anterior teeth to correct the open bite.

Key words: Mandibular incisor extraction, Open bite, Tongue hypertrophy, Tongue thrust habit, Orthodontic treatment, Case report

中图分类号:

R783.5

田磊, 刘宇妍, 王雨晴, 张芷钰, 孙秀梅. 单颌拔牙矫治Ⅲ°开并发舌体肥大1例报告及文献复习[J]. 吉林大学学报(医学版), 2026, 52(1): 236-245.

Lei TIAN, Yuyan LIU, Yuqing WANG, Zhiyu ZHANG, Xiumei SUN. Grade Ⅲ open bite complicated with tongue hypertrophy treated by mandibular incisor extraction：A case report and literature review[J]. Journal of Jilin University(Medicine Edition), 2026, 52(1): 236-245.

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Measurement	Normal （x±s）	Pretreatment	Posttreatment
SNA (°)	82.8±4.0	84.1	83.8
SNB (°)	80.1±3.9	80.7	82.2
ANB (°)	2.7±2.0	3.4	1.6
MP-SN (°)	32.5±5.2	35.2	32.4
U1-SN (°)	105.7±6.3	116.9	111.8
U1-NA (mm)	5.1±2.4	6.7	6.6
U1-NA (°)	22.8±5.7	32.8	28.1
L1-MP(°)	92.6±7.0	105.7	93.4
L1-NB (mm)	6.7±2.1	8.7	6.8
L1-NB (°)	30.3±5.8	41.6	28.0
U1-L1 (°)	125.4±7.9	102.1	122.4
Wits (mm)	-1.1±2.0	-2.4	-2.0
APDI (°)	86.0±4.0	80.8	85.5
ODI (°)	73.3±5.9	66.0	68.0
S-Go (mm)	80.0±4.0	79.7	82.1
N-Me (mm)	112.0±7.0	118.9	119.5
S-Go/N-Me (%)	63.0±2.0	67.0	68.7