骨性安氏Ⅱ类错的外科与正畸联合治疗

目的 :探讨外科与正畸联合治疗骨性安氏Ⅱ类错的方法和特点。方法 :总结分析近年来经外科与正畸联合治疗的骨性安氏Ⅱ类错病例 2 2例 ,介绍典型病例治疗过程 ,着重讨论拔牙时机、术前后正畸治疗特点及术式选择。结果 :本研究 2 2例患者经联合治疗后 ,颌骨关系正常 ,牙弓形态及曲线正常 ,牙排列整齐 ,咬合关系好 ,面形及功能均获明显改善 ,疗效满意。结论 :外科与正畸联合治疗是改正成人骨性安氏Ⅱ类错的有效方法 ,正确的术式选择及合理的正畸治疗是治疗成功的关键。     

骨性安氏Ⅱ类错(牙合)的外科与正畸联合治疗

目的:探讨外科与正畸联合治疗骨性安氏Ⅱ类错(牙合)的方法和特点.方法:总结分析近年来经外科与正畸联合治疗的骨性安氏Ⅱ类错(牙合)病例22例,介绍典型病例治疗过程,着重讨论拔牙时机、术前后正畸治疗特点及术式选择.结果:本研究22例患者经联合治疗后,颌骨关系正常,牙弓形态及(牙合)曲线正常,牙排列整齐,咬合关系好,面形及功能均获明显改善,疗效满意.结论:外科与正畸联合治疗是改正成人骨性安氏Ⅱ类错(牙合)的有效方法,正确的术式选择及合理的正畸治疗是治疗成功的关键.     

E线B线H线评价侧貌美唇美学一致性,敏感性的研究

目的；比较Ｅ线，Ｂ线，Ｈ线对侧貌唇美学评价的一致性，敏感性，方法：３０例侧貌美观的正常Ｈｅ及４７例侧貌不协调的安氏Ｉ，Ⅱ，Ⅲ类骨性错Ｈｅ进行Ｘ线头影测量，测量唇到Ｅ线，Ｂ线，Ｈ线的距离，结果：对正常Ｈｅ组Ｅ线的一致性最好，安氏Ｉ类骨性双颌骨突变组Ｂ线的敏感性高，安氏ＩＩ类１分类骨性Ｈｅ组Ｂ线对于上唇的敏感性较高，对于安氏Ⅱ类骨性错Ｈｅ组各线的判定不同，结论：Ｅ线在评价侧貌唇的美观上的一致性最好，Ｂ     

成人骨性安氏Ⅱ类1分类错的正颌-正畸联合治疗

目的 采用正畸-正颌手术联合治疗骨性安氏Ⅱ类Ⅰ分类错(牙合)患者,介绍手术前后正畸及术前的准备工作。方法 11例成人骨性安氏Ⅱ类Ⅰ分类错(牙合)患者,均经术前正畸-正颌手术-术后正畸的治疗过程。手术前后正畸目的是矫正上下颌前牙前突,排齐牙列,协调上下牙弓,平整牙(牙合)曲线,建立正颌术后良好的咬合关系。术前准备包括术前电脑模拟手术、模型外科、(牙合)板制作。结果 11例患者建立了良好的咬合关系及协调的上下颌骨关系,面容美观改善。结论 骨性错(牙合)畸形患者采用正畸-正颌联合治疗,能获得功能和美观的满意效果,术前正畸、电脑模拟手术、模型外科、(牙合)板制作及术后正畸,每一操作步骤的精确到位均十分重要。     

成人骨性安氏Ⅱ类1分类错(牙合)的正颌-正畸联合治疗

目的采用正畸-正颌手术联合治疗骨性安氏Ⅱ类Ⅰ分类错(牙合)患者,介绍手术前后正畸及术前的准备工作.方法11例成人骨性安氏Ⅱ类Ⅰ分类错(牙合)患者,均经术前正畸-正颌手术-术后正畸的治疗过程.手术前后正畸目的是矫正上下颌前牙前突,排齐牙列,协调上下牙弓,平整牙(牙合)曲线,建立正颌术后良好的咬合关系.术前准备包括术前电脑模拟手术、模型外科、(牙合)板制作.结果11例患者建立了良好的咬合关系及协调的上下颌骨关系,面容美观改善.结论骨性错(牙合)畸形患者采用正畸-正颌联合治疗,能获得功能和美观的满意效果,术前正畸、电脑模拟手术、模型外科、(牙合)板制作及术后正畸,每一操作步骤的精确到位均十分重要.     

成人严重骨性Ⅲ类错(牙合)畸形手术前后的正畸治疗

目的：研究成人严重骨性Ⅲ类错耠畸形在正颌外科治疗的术前与术后正畸的特点及难点。方法：成人严重骨性Ⅲ类错胎病例35例，对该类畸形的临床特点、正颌手术前后正畸治疗方法和注意事项进行分析研究。结果：术前正畸治疗必须完成个别牙齿错位的调整，纠正牙弓形态与宽度的不调和牙齿代偿的去除：术后正畸的主要目的是牙弓内残留间隙的关闭和咬合关系的进一步精细调整。结论：只有完善的术前、术后正畸治疗与正颌外科手术相互配合，才能较好地完成成人严重骨性Ⅲ类错胎的临床治疗。     

Tweed-Merrifield定向力原理在安氏Ⅱ类Ⅰ分类错(牙合)治疗中的应用

目的介绍Ｔｗｅｅｄ－Ｍｅｒｒｉｆｉｅｌｄ定向原理,探讨其在治疗安氏Ⅱ类Ⅰ分类错Ｈｅ的临床机理。方法通过评价临床治疗的１０例安氏Ⅱ类Ⅰ分类错Ｈｅ病例,介绍改进的Ｔｗｅｅｄ－Ｍｅｒｒｉｆｉｅｌｄ矫治方法及步骤,并分析矫治中使用的力系,同时介绍一典型病例的治疗过程及治疗结果。结果表明正确应用Ｔｅｗｗｄ－Ｍｅｒｒｉｆｉｅｌｄ原理在临床上能成功治疗安氏Ⅱ类Ⅰ分类错Ｈｅ,结论方丝弓是一种有效的矫治安氏Ⅱ类Ⅰ分     

安氏Ⅱ类一分类错He下颌运动轨迹研究

安氏Ⅱ类一分类错Ｈｅ包括有骨性错Ｈｅ和功能性错Ｈｅ。它们有着不同的病因机理和矫治原则，但临床对此两种错Ｈｅ的鉴别诊断有时却是较为困难的。本实验对３０例安氏Ⅱ类一分类错Ｈｅ患者进行了下颌运动学研究，以探讨骨性错Ｈｅ和功能性错Ｈｅ的下颌运动轨迹特征。结果表明，用下颌运动轨迹描记作为辅助性诊断手段，对骨性和功能性安氏Ⅱ类一分类错Ｈｅ进行鉴别诊断具有重要的临床价值。     

骨性安氏Ⅱ1的生长改良治疗

本文通过１６例骨性安氏Ⅱ＾１错Ｈｅ畸开的生长改良治疗,介绍了矫治器的组成及治疗方法。结果表明,颌外牵引有效地抑制了上颌向前的生长发育,斜面导板促进了下颌向前的生长发育,顺时针旋转下颌,改善了颜面外观。作者分析认为：①骨性安氏Ⅱ＾１错Ｈｅ畸形矫治的关键,首先是利用儿童生长发育的潜力,协调上下颌骨间关系,然后在此基础上协调Ｈｅ关系。②骨性安氏Ⅱ＾１的矫治主要是解决了长度和高度不协调,同时,通过改变后牙     

安氏Ⅲ类错He正畸前后颞下颌关节形态变化的研究

目的 探讨骨性和功能性Ⅲ类错Ｈｅ在正畸前、后颞下颌关节形态变化与颞下颌关节紊乱病（ＴＭＤ）之间的关系。方法 利用矫正薛氏位Ｘ线片在正畸前后对Ⅲ类骨性错Ｈｅ正畸前１９例和正畸后１１例、功能性错Ｈｅ正畸前２０例和正畸后１８例的双侧颞下颌关节的髁突居关节窝中的位置（前移、居中、后移）,从上述两类错Ｈｅ患者中各选５例做双侧颞下颌关节矢状位核磁共振扫描,观察正畸前、后关节盘的位置及形态变化。结果 正畸前Ⅲ类     

正畸-正颌联合治疗成人骨性Ⅲ类错(牙合)研究进展

成人严重骨性Ⅲ类错(牙合)是临床上骨性错(牙合)畸形最为常见的一种,不仅存在牙性问题,同时还伴有颌骨形态、位置的异常,严重影响患者面部美观、口颌功能及心理健康.正畸-正颌联合治疗是行之有效的手段.本文从正畸-正颌联合治疗适应证选择、手术时机、对软硬组织侧貌及稳定性的影响等方面做一综述.     

Severe skeletal Class III malocclusion treated without surgery or extraction

Among the malocclusions involving skeletal discrepancies, Class III occurs with the least frequency; however, it is also severe in the majority of cases. Compared with a Class II malocclusion, the mesial occlusion invariably manifests itself with greater deforming characteristics of facial harmony. The deficiency in the middle third of the face and/or the excessive length of the lower third of the face leads to significant loss of the profile's harmony. Good treatment strategies for this type of malocclusion could involve anything from intervening in the mixed dentition and/or permanent dentition in young adults to the combined orthodontic and surgical approach in patients without growth potential, who do not allow for compensations. This case report illustrates a Class III adolescent patient with severe facial profile deformity during the pubescent growth spurt, treated without extractions or orthognathic surgery.     

Scope and limitations of orthognathic surgery

Modern orthognathic surgical procedures allow correction of bony disproportion in almost any part of the face, but are limited in the fine tuning of tooth position and occlusion. However, carefully planned combined surgical and orthodontic treatment can produce dental and skeletal results of a high standard. If a GDP is presented with a malocclusion beyond the scope of normal orthodontic treatment, then referral to an oral surgery/orthodontic clinic is indicated. This article provides an overview of what the team on such a clinic can achieve.     

Survey of oral health-related quality of life among skeletal malocclusion patients following orthodontic treatment and orthognathic surgery

Objectives

The goal of this work was to conduct a survey of oral health-related quality of life (OHRQoL) among skeletal malocclusion patients who had undergone orthodontic treatment combined with orthognathic surgery.

Patients and methods

The study included 28 patients who had undergone orthodontic therapy combined with orthognathic surgery (surgical repositioning osteotomy) to treat skeletal malocclusion. OHRQoL was assessed based on a 14-item German version of the Oral Health Impact Profile (OHIP-G14) and an additional questionnaire developed by the authors to evaluate aspects of quality of life specific to skeletal malocclusion patients.

Results

The mean OHIP-G14 score demonstrates that the malocclusion patients have a lower OHRQoL than the general population. The information collected via our skeletal malocclusion questionnaire correlates with the patients’ perceived esthetic and functional outcomes of treatment as well as their psychological state and social interactions. Satisfaction with treatment outcomes and improved social interactions correlated with high OHRQoL scores. High OHRQoL scores significantly correlated with enhanced well-being and the intensification of social contacts.

Conclusion

Our skeletal malocclusion questionnaire provides useful additional information on specific aspects of skeletal malocclusion patients, mapping in a detailed fashion aspects of function, esthetics, psychological condition, and social interactions. OHIP-G14 scores correlated negatively with OHRQoL.     

Three-part bi-maxillary osteotomy: a case report involving resorbable plates

This case report describes a patient who presented with a severe class 2 skeletal discrepancy together with a Class II malocclusion and a large anterior open bite. The malocclusion and skeletal discrepancy were managed with a combination of orthodontic and orthognathic treatment. The orthognathic surgery was undertaken following orthodontic decompensation using sectional mechanics to allow a segmental bimaxillary osteotomy and genioplasty to be performed. Although the discrepancy was severe using this combination of treatment, a successful outcome, both facially and occlusally, was achieved.     

牙槽骨再生正畸治疗伴牙槽骨缺损的成人错畸形远期疗效评价

目的：评价牙槽骨再生正畸治疗伴牙槽骨缺损的成人错畸形的远期疗效。方法伴牙槽骨缺损的成人错畸形3例,平均年龄29岁。经正颌-正畸联合会诊制订治疗计划,按照牙槽骨再生正畸及正颌-正畸联合治疗模式,分别进行系统治疗并随访2~3 a。结果3例患者均顺利完成治疗,面型及咬合关系获得良好改善;牙槽骨缺损区正畸牙移动到位且未见医源性牙周并发症,牙槽骨缺损区骨量增加明显且远期效果稳定。结论针对伴牙槽骨缺损的成人患者,牙槽骨再生正畸是一种较为理想的技术。     

骨性Ⅱ类错(牙合)畸形患者侧貌相关分析及正畸正颌联合治疗后组织变化

目的 通过研究颌面部软硬组织变化情况来了解正畸-正颌联合治疗对骨性Ⅱ类错(牙合)畸形患者的疗效,并分析患者软硬组织之间的相关性,为联合治疗技术提供参考和指导.方法 选择23例骨性Ⅱ类错(牙合)畸形患者,分别在正畸-正颌联合治疗前后影像学资料中选取21项能够反映颌面部软硬组织、侧貌形态的参数进行对照分析,并对治疗前患者软硬组织进行相关性分析.结果 骨性Ⅱ类错(牙合)畸形患者治疗后相比治疗前所有参数中除ANS-Me/N-Me(%)、Pg-Pg′(mm)外,余下19项参数差异均有统计学意义(P<0.05);通过将患者治疗前的硬组织指标及其软组织侧貌美学指标进行相关性分析,可发现侧貌美学受很多硬组织参数影响.结论 正畸-正颌联合技术对于骨性Ⅱ类错(牙合)畸形的改善成效明显,骨性Ⅱ类错(牙合)畸形患者硬组织面型构成软组织面型的基础和支架,同时软组织也具有一定的独立性.     

Three-part bi-maxillary osteotomy: a case report involving resorbable plates

Abstract

This case report describes a patient who presented with a severe class 2 skeletal discrepancy together with a Class II malocclusion and a large anterior open bite. The malocclusion and skeletal discrepancy were managed with a combination of orthodontic and orthognathic treatment.

The orthognathic surgery was undertaken following orthodontic decompensation using sectional mechanics to allow a segmental bimaxillary osteotomy and genioplasty to be performed. Although the discrepancy was severe using this combination of treatment, a successful outcome, both facially and occlusally, was achieved.     

Chirurgische Untergesichtsverlängerung bei der Therapie von Patienten mit Klasse-II-Dysgnathien und skelettal tiefem Biss – "Short-face- Syndrom"

Among Angle Class II patients scheduled for orthognathic surgery, those with short face syndrome with skeletal deep bite only make up a small portion. Nevertheless, it represents a complex challenge for the orthodontist as well as for the surgeon with respect to the individual treatment goals. The harmony of facial relations is impaired in these patients: The skeletal lower face and consequently the soft tissue profile show a deficit in height compared to the midface. Lengthening of the lower face with its respective effect on facial aesthetics can only be corrected by causal therapy, i.e., a combined approach with surgical enlargement of the gonion angle. In this study, a therapy concept specifically suited for the correction of Class II deformities with short face syndrome is presented. Consequences for the skeletal and dental situation with their benefit for extraoral appearance were tested in a clinical trial (n=15, patients with class II deformities and short face syndrome). To evaluate skeletal and dental changes, cephalograms were taken prior to initiation of orthodontic treatment, 3 days after surgery but before initiation of postsurgery orthodontics, and 1 year after the end of treatment.