口腔医学研究

口腔医学研究 ›› 2026, Vol. 42 ›› Issue (4): 352-358.DOI: 10.13701/j.cnki.kqyxyj.2026.04.016

• 研究生病例精粹———口腔正畸学系列(4) • 上一篇    

成人重度拥挤伴侧切牙反牙合隐形拔牙矫治1例

张欢欢1, 赵婷婷1,2,3*   

  1. 1.口颌系统重建与再生全国重点实验室,口腔生物医学教育部重点实验室,口腔医学湖北省重点实验室,武汉大学口腔医(学)院, 湖北 武汉 430079;
    2.武汉大学口腔医院口腔正畸一科 湖北 武汉 430079;
    3.湖北省儿童牙颌面畸形临床医学研究中心 湖北 武汉 430079
  • 收稿日期:2026-03-20 发布日期:2026-04-23
  • 通讯作者: *赵婷婷,E-mail:zhaott1991@whu.edu.cn
  • 作者简介:张欢欢(1999~ ),女,辽宁人,硕士在读,研究方向:口腔正畸学。

Invisible Extraction Orthodontics for Adult Severe Crowding with Lateral Incisor Crossbite: A Case Report

ZHANG Huanhuan1, ZHAO Tingting1,2,3*   

  1. 1. State Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School and Hospital of Stomatology, Wuhan University, Wuhan 430079, China;
    2. Department of Orthodontics Division 1, Hospital of Stomatology, Wuhan University, Wuhan 430079, China;
    3. Hubei Provincial Clinical Research Center for Dentofacial Deformities in Children, School and Hospital of Stomatology, Wuhan University, Wuhan 430079, China
  • Received:2026-03-20 Published:2026-04-23

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摘要： 本病例系统报道1例成人重度牙列拥挤伴侧切牙反牙合、全口釉质发育不全患者的无托槽隐形拔牙矫治过程。结合患者主诉、临床检查及影像学资料,经综合评估后,最终制定拔除4颗第一前磨牙的隐形矫治方案。治疗期间,通过科学设计磨牙备抗、合适的附件放置、精细化控根移动及前牙内收等生物力学操作,在未使用种植钉支抗辅助的情况下,顺利达成预期矫治目标。治疗结束后,上下牙列排列整齐,双侧尖牙及磨牙均达到中性咬合关系,上下牙中线与面中线对齐,前牙覆牙合、覆盖恢复正常,咬合关系稳定,患者口腔功能得到明显改善。该病例提示对于合并侧切牙反牙合的成人重度拥挤患者,无托槽隐形矫治技术可通过精准的生物力学设计,有效矫正牙颌面畸形,在高效关闭拔牙间隙、解除侧切牙反牙合的同时,兼顾矫治过程的美观性与牙体组织健康,为此类病例提供了可行的临床矫治思路。

关键词: 正畸, 釉质发育不全, 无托槽隐形矫治, 隐形拔牙矫治, 拥挤

Abstract: This case systematically reports the process of invisible extraction orthodontic treatment with clear aligners for an adult patient with severe dentition crowding, lateral incisor crossbite, and generalized enamel hypoplasia. Based on the patient’s chief complaint, clinical examination, and imaging data, a comprehensive evaluation was conducted, leading to the final decision to implement an invisible orthodontic treatment plan involving the extraction of four first premolars. During the treatment, through scientifically design of molar anchorage, appropriate placement of auxiliary devices, refined controlled root movement, and anterior tooth retraction, the expected orthodontic goals were successfully achieved without the aid of mini-implant anchorage. Upon completion of the treatment, the upper and lower dental arches were neatly aligned, bilateral canines and molars achieved a Class Ⅰ occlusal relationship, the midlines of the upper and lower teeth aligned with the facial midline, and the overbite and overjet of the anterior teeth returned to normal. The occlusal relationship was stabilized, with significant improvements in the patient’s profile and oral function. This case suggests that for adult patients with severe crowding and lateral incisor crossbite, the clear aligner technology can effectively correct malocclusion through precise biomechanical design. It efficiently closes extraction spaces and completely resolves lateral incisor crossbite while maintaining aesthetic appeal and dental tissue health during treatment, providing a feasible clinical approach for such cases.

Key words: orthodontics, enamel hypoplasla, clear aligners, invisible extraction orthodontics, crowding