正畸、正颌联合矫治严重颅颌面畸形骨性双颌前突正畸、正颌治疗  

Treatment for skeletal bimaxillary protrusion by orthodontic and orthognathic surgery

作　　者：段银钟[1] 曾照斌[1] 

机构地区：[1]第四军医大学口腔医学院,西安710032

出　　处：《中国实用口腔科杂志》2011年第7期385-389,共5页Chinese Journal of Practical Stomatology

摘　　要：双颌前突畸形在正畸临床上比较常见,尤其是骨性双颌前突,严重影响患者的侧貌外形和美观。临床矫治欲达到理想的疗效也比较困难。本文结合临床这一常见的错畸形,首先介绍了双颌前突的一般情况,叙述了临床上对双颌前突的分类,常用两种分类方法,旨在更好地指导矫治计划的制定。本文就临床上的诊断问题进行了讨论。根据头影测量资料,一是可依据美容线(E线),评估双颌前突的程度,简单易行;二是可依据面平面,即鼻根点至硬组织颏前点的连线,此线与上下唇唇突点的距离可用来评估双颌前突的程度。牙性双颌前突是正畸矫治的适应证,骨性双颌前突一般首选正畸、正颌联合治疗,手术方法一般选择颌骨前部根尖下截骨后退术。术前术后均需进行常规的正畸治疗。手术治疗后,颌骨及牙齿可瞬间后移7.0mm左右,而软组织可后移5.0～6.0mm,美观效果明显改善,可达到满意的疗效,无其他不良反应出现。Bimaxillary protrusion is a common malocclusion,especially severe skeletal prognathism,which affects the profile and aesthetics.It is difficult to be treated and to get satisfactory results.This article describes the general situation and classifications about the bimaxillary protrusion firstly.It is classified into two categories in order to guide treatment planning.The diagnosis for bimaxillary protrusion is also discussed in this article.E-line（Esthetic line） and facial plane（N-Pog） are applied to evaluate the degrees of bimaxillary protrusion.Orthodontic treatment is applied to dental protrusion while orthognathic surgery,such as anterior bimaxillary subapical osteotomy,is applied to skeletal bimaxillary prognathism.Orthodontic treatment is a routine work for pre-and post-operations.Teeth and alveolar bone retreat for about 7 mm instantly while labial soft tissue for about 5～6 mm.The satisfactory results are obtained and the profile and aesthetics are improved without negative problems.

关 键 词：骨性双颌前突 正畸治疗 正颌外科 美容线 

分 类 号：R78[医药卫生—口腔医学]