多片段LeFortI型截骨矫治严重牙颌面畸形

目的：采用多片段Le Fort I型截骨术矫治严重牙颌面畸形，并为克服术后骨段固位不良之缺点自制一种腭侧固定夹板。方法；以该手术方法联合双侧下颌升支矢状劈开术（BSSRO）矫治上颌宽度不足伴上下颌其它严重畸形的患者19例。采用单纯多片段Le Fort I型截骨6例，联合BSSRO13例。19例中上颌两片段Le Fort I型截骨12例，3片段7例。结果：术后随访6例，平均22.6m,6/6间距离平均扩宽7.3mm,3/3间平均扩宽3.9mm。无严重并发症及明显复发，咬合关系满意。结论：应用良好的腭侧固定夹板，采用多片段Le Fort I截骨联合BSSRO可一次满意矫治严重双颌畸形。

MULTISEGMENTAL LE FORT I OSTEOTOMY FOR CORRECTION OF SEVEREMAXILLARY DEFORMITIES

Objective: Multisegmental Le Fort I osteotomy was performed for the correction of severe maxillary deformities. To improve the stability after segmental Le Fort I osteotomy, a new kind of palatal rigid fixed splint was created and used. Methods: 19 cases of severe bimaxillary deformities were operatively corrected, 6 patients with simple multisegmental Le Fort I osteotomies and 13 patients combined with bilateral sagittal split ramus osteotomies (BSSRO) . 12 two - segment and 7 three - segment Le Fort I osteotomies were performed. All cases were fixed with rigid internal fixation. A new kind of splint with two miniplates on the palatal surface of the maxilla was rigid fixed with 4 long screws for 6 weeks. Results: 16 cases have been followed - up for average 22. 6 months. The palatal suture expansion between 66were maximal 8. 5mm and minimal 6. 5mm (mean 7. 3mm), between 3|3 were maximal 5mm and minimal 3. 5mm (mean 3. 9mm) . All osteotomy lines healed well. There were no severe complications, no evident relapse. The occlusion was satisfied with the postoperative orthodontic treatment. Conclusion: When good palatal riged fixed splint is used, multisegmental Le Fort I osteotomy with BSSRO can satisfyingly correct severe bimaxillary deformities.