成人双侧唇腭裂前牙反牙合的非手术治疗

目的：在成人双侧Ⅲ度唇腭裂患者前牙反牙合治疗中应用小型下颌双侧后退位牙合板，适度后退下颌骨，评价其矫治前牙反牙合的临床效果。方法：应用小型下颌双侧后退位牙合板治疗48例成人双侧Ⅲ度唇腭裂术后前牙反牙合患者。在打开咬合的同时后退下颌骨，亦可同时侧方调位下颌骨，并同时粘固上下颌牙列托槽进行牙列的排齐整平。正畸治疗结束后进行缺牙区义齿修复。结果：患者侧貌在戴用后退位牙合板后明显改善，下颌骨整体后退，反牙合矫治时间较普通牙合板明显缩短。使患者避免了正颌手术。随访2年以上疗效稳定。结论：小型下颌双侧后退位牙合板适用于下颌可适度后退的成人双侧唇腭裂术后前牙反牙合患者。下颌骨整体地有效后退缩短了矫治时间，也使上颌扩弓的难度明显减少。该牙合板结构小巧不影响上下颌牙列托槽的粘固，是较固定反式TBA更为理想的装置。

Non-surgical treatment of the adult anterior crossbite with bilateral cleft lip and palate

Objective:The small backward mandibular occlusal plate is used to anterior crossbite therapy of adult pa-tients with bilateral cleft lip and palateⅢ°,and backing mandible moderatly,to evaluate clinical effect of adult bilateral cleft lip and palate correction of anterior crossbite. Method:48 cases of anterior crossbite were treated by small backward mandibular occlusal plate. While open occlusal,mandible was back and turn aside. At the same time,superior and mandibu-lar teeth are bonded bracket to alignment and leveling.The hypodontia carry out dentures after the end of orthodontic. Re-sult:Profile form of patient was improved obviously after wearing backward occlusal plate,because of overall mandible back, crossbite correction time than ordinary occlusal plate significantly shortened. So that patients avoid orthognathic surgery. Ef-ficacy and stability were followed for 2 years. Conclusion:The small backward mandibular occlusal plate apply to adult an-terior crossbite patients with modest retreat mandibular bilateral cleft lip and palate. Back mandible effectively shorten the overall treatment time,but also to the difficulty of the maxillary arch expansion significantly reduced. This compact occlusal plate does not affect the upper and lower dentition bracket cements. It is more ideal device than the modified fixed reverse Twin-block appliance.