骨性开畸形正颌外科手术前后的正畸治疗  

Pre- and Post-surgical orthodontic treatment for skeletal open bite

作　　者：周彦恒[1] 胡炜[1] 孙燕楠[1] 王兴[2] 李自力[2] 张君[3] 

机构地区：[1]北京大学口腔医学院正畸科,100081 [2]北京大学口腔医学院口腔颌面外科,100081 [3]山东医科大学口腔医学系

出　　处：《中华口腔医学杂志》2001年第3期225-228,共4页Chinese Journal of Stomatology

摘　　要：目的　通过分析总结骨性开畸形手术前后正畸治疗的原则和方法 ,以指导临床。方法　前牙开畸形 32例 ,男性 9例 ,女性 2 3例 ,开度 1～ 8 5mm ,平均 4mm ,31例伴下颌前突 ,1例伴下颌后缩。单纯术前正畸 8例 ,单纯术后正畸 3例 ,余 2 1例在手术前后均行正畸治疗。结果　术前正畸疗程为 4～ 33个月 ,平均 12个月 ;术后正畸疗程为 3～ 17个月 ,平均 8 5个月。开畸形的术前治疗为 :排齐上下牙列 ,解除牙列拥挤 ;去代偿治疗 ;避免上下切牙向伸长移动 ;上下牙列宽度不调时 ,可轻度扩大上颌牙弓。术后正畸治疗为 :关闭牙列术后间隙 ;进一步排齐牙列 ;调整上下牙列的唇颊向倾斜度 ;上下颌内垂直牵引 ,防止开复发 ;上下颌间Ⅱ类或Ⅲ类牵引 ,调整磨牙关系。结论通过系统的术前术后正畸治疗及正颌外科手术 ,可矫正前牙开畸形 ,并取得良好矫治效果。Objective To Study the principles and rules of pre and post surgical orthodontic treatment for skeletal open bite patients. Methods Thirty two surgically treated open bite cases were analyzed, of which 9 were males, and 23 were females, aged from 16 to 38. Open bite was from 1 to 8 5 mm, average was 4 mm. 31 patients were Class Ⅲ malocclusion, while 1 patient was Class Ⅱ malocclusion. Results ① Totally 21 patients were treated with orthodontics before and after orthognathic surgery, while 8 patients had pre surgical orthodontics only, and other 3 had post surgical orthodontics only. The duration for pre surgical orthodontics was from 4 to 33 months, average was 12 months. The duration for post surgical orthodontics was from 3 to 17 months, average was 8 5 months. ②Presurgical orthodontic treatment included: Alignment of arches, decompensation of incisors, avoiding extrusion of incisors, and slight expansion of arches for coordination of arches. ③ Post surgical orthodontic treatment included: Closure of residual spaces in the arches, realignment of arches, vertical elastics and Class Ⅱ or Ⅲ intermaxillary elastics. Conclusions Skeletal open bites require combined orthodontic orthognathic surgery for optimal and esthetical pleasing results.

关 键 词：口腔畸形 正畸学 正颌外科 骨正开He畸形 

分 类 号：R783.5[医药卫生—口腔医学] R782.2[医药卫生—临床医学]