Le FortⅠ型骨切开上颌骨整体后退术矫治骨性Ⅱ类上颌骨前突畸形  

Total maxilla setback by Le Fort Ⅰosteotomy for correction of maxillary prognathism with skeletal Class Ⅱ malocclusion

作　　者：刘曙光[1] 艾伟健[1] 段培佳[2] 周会喜[1] 薛国初[1] 缪耀强[2] 朱晓斌[3] 

机构地区：[1]广东省口腔医院.南方医科大学附属口腔医院口腔颌面外科 [2]广东省口腔医院.南方医科大学附属口腔医院口腔正畸科 [3]粤诚牙科技术开发中心,广东广州510280

出　　处：《中国口腔颌面外科杂志》2008年第4期261-265,共5页China Journal of Oral and Maxillofacial Surgery

基　　金：广东省医学科学技术研究基金(A2005121)~~

摘　　要：目的:探讨LeFortⅠ型骨切开(LeFortⅠosteotomy)上颌骨整体后退术在矫治骨性Ⅱ类上颌骨前突畸形中的价值。方法:对16例骨性Ⅱ类上颌前突患者(上颌骨前突伴下颌骨后缩14例,其中同时伴颏后缩6例;单纯上颌骨前突2例)进行外科-正畸联合治疗。患者治疗前头影测量∠ANB为7.0°～13.1°,平均9.3°。行LeFortⅠ型骨切开上颌骨整体后退术,其中14例同期行双侧下颌支矢状骨劈开术(bilateral sagittal split ramus osteotomy,BSSRO)前移下颌骨,6例行颏成形术(genioplasty)前移颏部。结果:本组行LeFortⅠ型骨切开上颌骨整体后退4～8mm,14例BSSRO下颌骨前移4～7mm,6例颏成形术颏前移6～8mm。1例一侧腭降动脉术中损伤断裂,经结扎处理,无感染及骨块坏死。16例患者伤口均一期愈合。术后及正畸结束后∠ANB为1.6°～3.5°,平均2.9°。结束治疗后随访6～24个月,牙弓形态及!曲线正常,牙排列整齐,咬合关系良好,外形明显改善,疗效满意。结论:对于骨性Ⅱ类上颌骨前突畸形患者,LeFortⅠ型骨切开上颌骨整体后退术是一种安全、合理、有效的正颌外科术式。PURPOSE： To evaluate the role of total maxilla setback by Le Fort Ⅰosteotomy for correction of maxillary prognathism with skeletal Class Ⅱ malocclusion. METHODS： Sixteen patients of maxillary prognathism with skeletal Class Ⅱ malocclusion underwent joint orthodontic treatment and orthognathic surgery were included.Fourteen of them exhibited mandibular deficiency while the other two had not.Total maxilla setback by Le Fort Ⅰosteotomy was performed in all cases,while bilateral sagittal split ramus osteotomy （BSSRO） was applied simultaneously in 14 cases to advance their mandibles and the other 6 cases simultaneously underwent genioplasty for the purpose of advancement of their chins.RESULTS： The distance of maxilla setback was from 4 to 8mm in all cases with Le Fort Ⅰosteotomy. In the cases with BSSRO, mandible advancement was from 4 to 7 mm and chin advancement was from 6 to 8 mm in 6 cases with genioplasty. All wounds healed well without any serve complication, even in one case greater palatine artery injury occurred. After 6 to 24 months of clinical follow-up following joint orthodontic treatment and orthognathic surgery,all patients regained satisfactory occlusal results and pleasing appearances. CONCLUSION： Total maxilla setback by Le Fort Ⅰosteotomy is an effective way to cure the patients of maxillary prognathism with skeletal Class Ⅱ malocclusion.

关 键 词：LeFortⅠ型骨切开 上颌骨后退 上颌骨前突 骨性Ⅱ类错[牙合] 

分 类 号：R782.2[医药卫生—口腔医学]