外科-正畸治疗下颌骨偏斜的Ⅲ类骨性畸形

目的　分析下颌骨偏斜的Ⅲ类骨性畸形的颅面形态特征,总结采用外科-正畸治疗矫治此类畸形中正畸治疗的特点及难点。方法　总结四川大学华西口腔医院通过外科-正畸治疗完成的下颌骨偏斜Ⅲ类骨性畸形病例25例,通过治疗前后患者资料的对比分析,对该类畸形的临床特点、正颌手术前后正畸治疗方法进行了探讨。结果　骨性Ⅲ类下颌骨偏斜畸形是合并有矢状向及冠状向的错畸形,正颌手术前的正畸治疗主要是平整协调上下牙弓形态和去除各类牙代偿,正颌手术后的正畸治疗为咬合的精细调节。经外科-正畸治疗,25例下颌骨偏斜的骨性III类畸形患者的形态和功能均得到改善。结论　下颌骨偏斜的Ⅲ类骨性畸形的临床表现复杂,有别于单纯的骨性Ⅲ类畸形,正颌手术前后的正畸治疗是保证矫治效果、达到功能形态俱佳的关键。

Combined Orthodontic-orthoganthic Surgery to Treat Asymmetric Mandibular Excess Malocclusions

Objective To discuss the skeletal and dentoalveolar characteristics of asymmetric mandibular excess malocclusions and to discuss the procedures of combined orthodontic_orthonganthic surgery treatments of asymmetric mandibular excess malocclusions.Methods 25 cases treated by combined orthodontic_orthognathic surgery treatments were reviewed to find out the specialties of this kind of therapy.Results The asymmetric of mandible presents anterior and posterior teeth tipped both sagitally and horizontally, as well as upper and lower jaws incompatibility. The pre_surgical orthodontic treatments included decomposition of anterior and posterior teeth, leveling and aligning the teeth etc. The post_surgical orthodontic treatments were to detail the occlusions. The patients all got functional and aesthetic good results after the combined orthodontic_orthognathic surgery treatments.Conclusion The asymmetric mandibular excess affects the harmony of the face badly, and the correction of it must be carried out by the combined orthodontic_orthognathic surgery treatments. The pre_and post_surgical orthodontic treatments are the key stages to make the skeletal corrections stable.