应用颌骨牵引成骨技术行下颌前部加宽术

目的 临床矫治上下颌骨宽度不调一下颌弓狭窄的病例时，既往采用的方法是正畸治疗调整下颌牙列内牙轴的方向。实际上这不是真正意义的下颌增宽，矫治后的效果已令人怀疑。运用颌骨牵引延长技术，使真正的下颌骨增宽成为可能。本文拟就运用颌骨牵引延长技术治疗下颌弓狭窄的手术程序、手术方法及手术效果、注意事项等作一探讨。方法 3例病人均为发育性下颌弓狭窄，同时伴有下颌后缩或上颌前凸畸形。手术分两个阶段：第一阶段行下颌骨前部加宽术，全麻下经口内入路行下颌正中截骨术，安置牵引器，按颌骨牵引成骨技术常规行牵引加力，并按常规拆除牵引器。第二阶段行正颌外科手术矫正主要的颌骨畸形。两阶段之间应用正畸技术调整牙轴方向、排齐牙列并去代偿。结果 第一阶段手术以后，下颌骨前部被延长7mm～10mm，新形成骨骨质良好，经正畸治疗和正颌外科手术治疗后病人面型及咬合关系良好，经复查效果稳定。结论 颌骨牵引成骨技术可用于下颌骨弓狭窄的病人的矫治，该技术效果肯定，手术并不复杂，术后反应不犬，宜于推广使用。

The anterior mandibular expansion with the technique of distraction osteogenesis

Objective When clinical correction of the narrowing of mandibular arch, the existing protocol was correcting the teeth axis of mandible. It was not the real expansion of the mandibular arch, the effect of correction is suspected. It is possible to use the technique of distraction osteogenesis to make the real expansion of the mandibular arch. In this paper we want to discuss the surgical procedures, effects, and cautions of the technique. Methods Three cases of patient with developmental narrowing of the mandibular arch, associate with retrognathia of mandible or protrusion of maxilla. The correcting plan was divided into 2 stages: First, expansion the anterior port of mandible or expansion the maxilla simultaneously. Second, orthognathic surgery procedured to correct the associate deformities. The orthodontic techniques were used to align the teeth between the two stages. Results After the expansion, the anterior part of patients' mandible were widened 7mm-10mm. And after the operations of the second stage, the patients' profile and occlusion were satisfied and stable. Conclusion The technique of distraction osteogenesis can be used to correct of the narrowing of the mandibular arch. It is easily to spread with its uncomplicated procedures, little postoperatively reaction and affirmative effects.