凹面型患者的正畸正颌联合治疗(1)
[摘要]目的：探讨正畸正颌联合治疗凹面型患者的临床疗效。方法：本研究选取52例凹面型患者，治疗前后对比临床评价面部畸形的矫治效果，采用正畸正颌外科联合治疗，并分别于术前、治疗后1周、治疗后12个月拍摄头颅定位侧位/CBCT，测量A点水平移动量和ANB角变化。结果：术后，上颌骨前移明显，ANB角增加7°～10°，面部软组织鼻尖点、鼻底点及上唇最突点明显前移，面中部外形得到明显改善，上下前牙获得正常覆牙合、覆盖关系。随访12～36个月，面部外形及咬合关系保持稳定。结论：凹面型患者采用正畸正颌联合治疗可取得良好效果，并避免了口颌系统继发畸形和功能障碍的发生。
[关键词]凹面畸形；反牙合；正畸正颌联合治疗；头影测量分析
[中图分类号]R783.5 [文献标志码]A [文章编号]1008-6455(2018)12-0004-04
The Effect of Orthodonticorthognathic Treatments for Concave Type Patients
, http://www.100md.com
TAO Yong-wei1，REN Zhan-ping1，GUO Yan1，WANG Shuang2，HOU Yu-xia2，BI Si-si1，JI Ling-ling2，ZOU Min2，LI Jin-feng1，ZHANG Zhi-yong2，ZOU Rui2
(Deptartment of Craniofacial Plastic Surgery；2.Deptartment of Orthodontics，Xi 'an Jiaotong University Stomatological Hospital，Xi’an 710004，Shaanxi，China)
Abstract： Objective To explore the effect of orthodonticorthognathic treatments on concave type patients. Methods 52 concave patients were included in this study，then compared the clinical effects of facial deformities before and after treatment. Lateral cephalograms/CBCT was taken before surgery， one week after orthognathic surgery and 12 months after orthognathic surgery.the position of point A on horizontal direction and ANB angles were collected and analyzed.Results The maxillary moved forward obviously，the ANB angles increased 7 to 11degrees after treatment.As regard to the soft tissues，the nasal tip，the base of the column，and the protruding point of the upper lip were moved forward prominently.The appearance of the middle face was obviously improved，and the upper and lower front teeth got normal overlap and overbite relation.Facial appearance and occlusal relationship remained stable during the follow up period of 12 to 36 months. Conclusion The combined orthodontic and orthognathic treatment for concave patients has achieved good results and avoided secondary deformities and dysfunction of the oral and maxillofacial system.
, 百拇医药
Key words： concave deformity； reverse occlusion； orthodonticorthognathic treatments； cephalometric analysis
凹面畸形是臨床上较为常见的一种面部畸形，特别严重的凹面型患者同时还伴有牙齿咬合错乱，颌骨形态、位置的异常，这均严重影响患者面部美观、口腔功能及心理健康[1-2]。目前，治疗凹面畸形的方法众多，总体上需要根据患者不同的年龄段，畸形严重程度来选择适宜的治疗方案方能取得良好效果。近年来，笔者科室采用正畸正颌外科联合治疗52例面中部凹陷畸形患者，均取得了满意效果，现将结果报道如下。
1 资料和方法
1.1 临床资料：收集2011年-2016年于西安交通大学口腔医学院颅颌面整形创伤外科收治的资料完整的52例凹面畸形患者资料进行回顾性分析， 其中男29例， 女23例， 年龄最大37岁， 最小13岁，平均为23.5岁。
1.2 方法
1.2.1 操作方法：52例患者，其中27例实施双颌手术(上颌骨Le FortⅠ型截骨术+下颌骨双侧升支矢状劈开后退术)，15例实施单颌手术(13例下颌骨双侧升支矢状劈开后退术，2例上颌骨Le Fort 型截骨前徙术)；另外10例患者中，6例采用上颌骨牵张成骨和扩弓治疗，3例采用外牵引装置，1例唇腭裂患者采用上颌骨牙支持式牵张成骨器治疗。, 百拇医药(张智勇 邹蕊 陶永炜 任战平 郭彦 王爽 侯玉霞 毕思思 吉玲玲 邹敏 李锦峰)
[关键词]凹面畸形；反牙合；正畸正颌联合治疗；头影测量分析
[中图分类号]R783.5 [文献标志码]A [文章编号]1008-6455(2018)12-0004-04
The Effect of Orthodonticorthognathic Treatments for Concave Type Patients
, http://www.100md.com
TAO Yong-wei1，REN Zhan-ping1，GUO Yan1，WANG Shuang2，HOU Yu-xia2，BI Si-si1，JI Ling-ling2，ZOU Min2，LI Jin-feng1，ZHANG Zhi-yong2，ZOU Rui2
(Deptartment of Craniofacial Plastic Surgery；2.Deptartment of Orthodontics，Xi 'an Jiaotong University Stomatological Hospital，Xi’an 710004，Shaanxi，China)
Abstract： Objective To explore the effect of orthodonticorthognathic treatments on concave type patients. Methods 52 concave patients were included in this study，then compared the clinical effects of facial deformities before and after treatment. Lateral cephalograms/CBCT was taken before surgery， one week after orthognathic surgery and 12 months after orthognathic surgery.the position of point A on horizontal direction and ANB angles were collected and analyzed.Results The maxillary moved forward obviously，the ANB angles increased 7 to 11degrees after treatment.As regard to the soft tissues，the nasal tip，the base of the column，and the protruding point of the upper lip were moved forward prominently.The appearance of the middle face was obviously improved，and the upper and lower front teeth got normal overlap and overbite relation.Facial appearance and occlusal relationship remained stable during the follow up period of 12 to 36 months. Conclusion The combined orthodontic and orthognathic treatment for concave patients has achieved good results and avoided secondary deformities and dysfunction of the oral and maxillofacial system.
, 百拇医药
Key words： concave deformity； reverse occlusion； orthodonticorthognathic treatments； cephalometric analysis
凹面畸形是臨床上较为常见的一种面部畸形，特别严重的凹面型患者同时还伴有牙齿咬合错乱，颌骨形态、位置的异常，这均严重影响患者面部美观、口腔功能及心理健康[1-2]。目前，治疗凹面畸形的方法众多，总体上需要根据患者不同的年龄段，畸形严重程度来选择适宜的治疗方案方能取得良好效果。近年来，笔者科室采用正畸正颌外科联合治疗52例面中部凹陷畸形患者，均取得了满意效果，现将结果报道如下。
1 资料和方法
1.1 临床资料：收集2011年-2016年于西安交通大学口腔医学院颅颌面整形创伤外科收治的资料完整的52例凹面畸形患者资料进行回顾性分析， 其中男29例， 女23例， 年龄最大37岁， 最小13岁，平均为23.5岁。
1.2 方法
1.2.1 操作方法：52例患者，其中27例实施双颌手术(上颌骨Le FortⅠ型截骨术+下颌骨双侧升支矢状劈开后退术)，15例实施单颌手术(13例下颌骨双侧升支矢状劈开后退术，2例上颌骨Le Fort 型截骨前徙术)；另外10例患者中，6例采用上颌骨牵张成骨和扩弓治疗，3例采用外牵引装置，1例唇腭裂患者采用上颌骨牙支持式牵张成骨器治疗。, 百拇医药(张智勇 邹蕊 陶永炜 任战平 郭彦 王爽 侯玉霞 毕思思 吉玲玲 邹敏 李锦峰)