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KCI등재 학술저널

심한 단안모의 골격성 III급 부정교합 환자에서 교합 고경의 증가: 가철성 장치와 보툴리늄 톡신의 이용

Increase in Occlusal Vertical Dimension in a Patient with Skeletal Class III Malocclusion and Severe Hypodivergent Pattern: Utilization of Removable Appliance and Botulinum Toxin

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Clockwise rotation of the mandible has been found effective in correcting Class III malocclusion with anteroposterior skeletal discrepancy. However, increasing the occlusal vertical dimension in severe hypodivergent patients poses a significant chal-lenge. This case report describes a camouflage treatment approach in a patient with severe hypodivergent Class III malocclu-sion. Treatment was done using a removable appliance and application of botulinum toxin A to increase the occlusal vertical dimension. A 25-year-old male patient presented with an anterior crossbite, Class III molar relationship, deep overbite, and prognathic chin. Cephalometric analysis revealed a skeletal Class III relationship (ANB -3.3°) and severe hypodivergence (Go-Me to FH plane angle 6.5°). An upper removable acrylic appliance, consisting of an inverted labial bow, anteroposterior expansion screw, and posterior bite block, was applied to correct the anterior crossbite and reduce the overbite. Fixed ortho-dontic appliances were subsequently used to extrude the posterior teeth and align the dentition. Bilateral injections of botu-linum toxin A were done on the masseter muscle to reduce muscle tone. After 18 months of treatment, normal occlusion and good interdigitation were achieved, and his facial profile was dramatically improved due to mandibular backward rotation.

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