성인 골격성 lll급 부정교합 환자의 비수술적 교정치료에서 골격성 고정원을 활용한 교합 평면의 회전

Skeletal Anchorage for Occlusal Plane Rotation in Non-Surgical Orthodontic Management of Adult Skeletal Class lll Malocclusion

Clockwise rotation of the flattened maxillary occlusal plane and an increased maxillary incisor display are key esthetic objectives in orthodontic treatment of adult skeletal Class III patients who refuse orthognathic surgery. This case report describes a 33-yearold male with an ANB of –1.7° and a flat occlusal plane (FH-OP 5.3°), treated with premolar extractions and skeletal anchorage to achieve occlusal plane control. The treatment plan involved extraction of the maxillary second premolars and mandibular first premolars. Posterior bite stops were first applied to disclude the occlusion and utilize the increased vertical dimension, which facilitated maxillary incisor extrusion and induced clockwise rotation of the upper occlusal plane. In the subsequent stage, mandibular miniscrews were used to achieve anterior intrusion, and cervical traction was applied to re-establish proper incisor inclination. After 38 months, Class I canine and molar relationships were established, with 6.2° clockwise rotation of occlusal plane, 3.5 mm extrusion of the maxillary incisor, and 7.5 mm retraction with 1.5 mm intrusion of the mandibular incisor. The smile arc and maxillary incisor display improved significantly with no periodontal complications. This case demonstrates that clockwise occlusal plane rotation, supported by skeletal anchorage, can provide effective esthetic and functional outcomes in nonsurgical orthodontic treatment of adult Class III malocclusion.