应用隐形矫治器治疗成年人骨性错牙合畸形，特别是在拔牙病例中的应用，一直是隐形矫治技术的难点之一。本科室于2019年3月收治1例30岁女性患者，患者因“牙不齐，嘴凸”就诊，寻求矫治以改善面型。患者双侧尖磨牙远中关系，上下颌前牙唇倾，深覆盖；影像学检查，ANB角为6.2°，骨性Ⅱ类错牙合。通过减数4颗第一前磨牙，配合4枚微种植钉，经过20个月的治疗，患者拔牙间隙关闭完成，牙列整齐，咬合关系良好；前牙内收，下颌骨逆旋，软组织侧貌得到明显改善。应用隐形矫治器配合微种植体支抗可以在成年人拔牙病例中实现良好的牙齿三维方向控制，为临床医师治疗该类患者提供参考。

Application of invisible orthodontic appliances in the treatment of adult skeletal malocclusions， especially in the cases requiring tooth extraction， has always been one of the challenges in invisible orthodontic technology. Our department received a 30-year-old female patient in March 2019； the patient presented with complaints of “crooked teeth and protruding mouth，” seeking orthodontic treatment to improve her facial profile. The patient had bilateral distal molar relationship， proclined maxillary and mandibular anterior teeth， and deep overjet； radiographic examination revealed an ANB angle of 6.2°， indicating a skeletal Class Ⅱ malocclusion. By extracting four first premolars and using four miniscrews， after 20 months of treatment， the extraction spaces were fully closed， the dental arch was aligned， and the occlusal relationship was favorable； the anterior teeth were retracted， the mandible showed a reverse rotation， and the soft tissue profile was significantly improved. Application of invisible orthodontic appliances in conjunction with miniscrews anchorage can achieve good three-dimensional control of tooth movement in adult extraction cases， providing a reference for clinical practitioners treating such patients.