颌骨牵引成骨术术前术后正畸治疗的初步研究

目的 探讨颌骨牵引成骨术术前术后正畸治疗的要求和原则。方法 对４例患者行颌骨牵引成骨术，年龄１９～２５岁，平均２１．５岁。４例分别行术后、术前术后正畸治疗。结果 ①颌骨牵引成骨术的术前正畸治疗较为简单，一般情况在短时间内排齐上下牙列，便于不锈钢圆丝的应用。②颌骨牵引成骨术的术后正畸治疗最具特色且较为复杂。术后正畸的首要任务是采用颌间垂直牵引，使脱离咬合的后牙在短时间内建立Ｈｅ关系。在垂直牵引时，宜采用非常轻力。有些患乾需要采用颌间交互牵引，在纠正牙区开Ｈｅ的同时，敌正后牙的覆盖的关系。③颌骨牵引成骨术后，有些患者需要扩大上颌牙弓，矫正后牙的反Ｈｅ。④颌骨牵引成骨术后，由于肌肉的牵拉，颌骨有复发的趋势，因此除在骨牵引成骨术后保留骨牵引器２～３个月外，还应在术后正畸治疗时，尽早换用较粗的唇弓，以利于进行Ⅱ类或Ⅲ类颌

Preliminary study on orthodontic treatment before and after distraction osteogenesis

OBJECTIVE: To get some guidelines for the orthodontic treatment before and after distraction osteogenesis (DO). METHODS: DO was performed in 4 patients maxilla and two for mandible. The patients were aged from 19 to 25 (average 21.5). We try to sum up the procedures and clinical experiences of pre- and post-surgery orthodontics. RESULTS: The procedures and experiences obtained are the followings: 1. Pre-surgery orthodontics for DO is simplified as alignment of dental arch in a short period. 2. Post-surgery orthodontics for DO is more complicated and peculiar. The main task is to make the opened posterior teeth occlude as soon as possible by light force vertical elastics. At the same time, some cross elastics may be needed for correction of posterior occlusal relationship. 3. Expansion of upper arch may be needed in some patients because of constricted dental arch. 4. Class II or III elastics may be used for prevention of relapse after DO. CONCLUSIONS: DO is a new technique in orthognathic surgery. Post-surgery orthodontics is more complicated and important in the treatment course.