개방교합과 안면 비대칭을 보이는 골격성 II급 부정교합 환자의 비수술적 치료

Nonsurgical Orthodontic Treatment of Skeletal Class II Patient with Anterior Open Bite and Facial Asymmetry

In cases of patients with anterior open bite and facial asymmetry, particularly those with compromised temporomandibular joint (TMJ) stability, non-surgical camouflage treatments require a detailed and nuanced approach. TMJ instability, which often leads to mandibular deviation, complicates the functional and aesthetic correction. The initial evaluation of both functional asymmetry and skeletal asymmetry becomes essential. A critical step in managing these cases involves the use of a stabilization splint prior to orthodontic treatment. This approach aims to determine a reproducible and stable mandibular position, setting a foundation for subsequent corrective measures. This case report underscores the effectiveness of employing a mandibular stabilization splint in conjunction with intrusion of maxillary molars. This strategy targets the elimination of functional asymmetry and allows for a thorough re-evaluation of skeletal asymmetry. Despite initial presentation of facial asymmetry, a detailed assessment, including CBCT analysis, revealed that the skeletal asymmetry was not significant. This finding suggested that the observed facial asymmetry was largely attributable to functional discrepancies rather than skeletal imbalances. Focusing on correcting functional asymmetry, it was possible to significantly improve both the anterior open bite and facial asymmetry through non-surgical treatment. The treatment results highlight the potential of non-surgical treatment to effectively address complex malocclusions, offering patient significant improvements without the need for surgical intervention. (Clin J Korean Assoc Orthod 2024;14(1):9-20)