下颌角外板矢状劈除在下颌角肥大矫治中的应用

目的探讨口内入路下颌角外板矢状劈除术在下颌角肥大矫治中的临床效果,并且比较传统与改良的各种下颌角截骨手术方法的利弊.方法对15例下颌角肥大患者,根据其临床分型,分别施行口内入路下颌角外板矢状劈除术,必要时辅以下颌角全层截骨.结果术后对15例下颌角肥大患者6个月至2年的随访,双侧下颌角间距有明显缩小,双下颌角间距与双颧间距之比平均从87.64%下降到82.78%,并且术后下颌骨升支与体部的角度接近正常,侧面观形态自然,弧线优美,体表无瘢痕.结论该手术方法不仅能有效矫治以下颌角肥大为表现的下面部过宽,而且术后保持了正常下颌骨侧面应有的自然形态,达到了下颌截骨术后下颌骨整体形态的协调美观,是目前较为理想的下颌角肥大矫治术式.

Application of lateral cortex around mandibular angle osteotomy in patient with prominent mandibular angle

Objective To discuss and evaluate the clinical effects of lateral cortex around the mandibular angle osteotomy, and to compare the advantages and disadvantages of the traditional and modified mandibular angle osteotomy methods. Methods Based on the clinical classification, 15 patients underwent the osteotomy of lateral cortex around the mandibular angle by intraoral approach, and full-layer mandibular angle osteotomy was performed in some patients if necessary. Results From 2002, the bigonial distance was effectively reduced in 15 patients, and the ratio of bigonial distance to bizygomatic distance was decreased from 87.64% to 82.78 % after 6 months to 2 years follow-up, and also after operation, the gonial angle was close to normal numerical value and the lateral configuration was natural. The most important point was that there was no scar on the skin. Conclusions This method is an ideal one at present because it effectively reduces the lower face width of patient with prominent mandibular angle and it retains the natural profile of the mandible. The whole configuration of the mandible after the mandibular angle osteotomy is harmony and slinky.