手术优先矫治成人骨性Ⅲ类错（牙合）畸形的临床效果  

Clinical outcomes of surgery-first approach correcting adult skeletal class Ⅲ malocclusion

作　　者：吴国平[1] 李春龙[1] 上官文松 周滨[1] 戴浩[1] 张文文[1] 王树 

机构地区：[1]南京医科大学附属友谊整形外科医院,210029

出　　处：《中华医学美学美容杂志》2017年第6期364-367,共4页Chinese Journal of Medical Aesthetics and Cosmetology

摘　　要：目的 探讨手术优先（SFA）方案矫治成人骨性Ⅲ类错（牙合）畸形的临床效果.方法 对28例成人骨性Ⅲ类错（牙合）畸形患者进行SFA的双侧下颌升支矢状劈开截骨和颏成形术,术后2～4周开始正畸治疗.在手术前（T1）、手术后1周（T2）、手术后6个月（T3）拍摄头颅定位侧位片,进行头影测量分析.结果 28例均对效果满意,无并发症发生,平均疗程13.2个月.Po点和B点在T2较T1分别后退（7.74±3.93） mm（P＜0.01）,（8.13±3.84） mm（P＜0.01）,上移（2.73±1.83） mm,（2.76±1.67） mm,在T3较T2分别前移（2.36±1.23） mm,（2.66±1.65） mm,下移（2.16±1.37） mm和（1.21±0.87）mm.T3与T2差异无统计学意义（P＞0.05）.∠SNB和∠GA在T2较T1分别减小（3.74±1.61）°（P＜0.01）,（3.41±1.87）°（P＜0.01）,T3较T2轻微增大,差异无统计学意义（P＞0.05）.结论 SFA结合术后快速正畸治疗矫治成人骨性Ⅲ类错（牙合）畸形可行,疗程短,能更快获得面部轮廓和咬合功能改善,降低正畸治疗难度和时间,患者更易接受.Objective To explore the clinical effect of surgery-first approach （SFA） for correcting adult skeletal class Ⅲ malocclusion deformity patients.Methods A total of 28 adult patients diagnosed with skeletal class Ⅲ malocclusion were treated.Bilateral sagittal split ramus osteotomy （BSSRO） and geniplasty were performed without presurgical orthodontics treatment;postoperative orthodontics treatment was carried out after a healing period of 2-4 weeks.Lateral cephalometric radiographs were taken preoperatively （T1）,within a week posoperatively （T2） and six months posoperatively （T3）;cephalometric measurements were carried out by the software.Results All the patients were satisfied with the effect,no complications occured.The mean postoperative orthodontics treatment duration was 13.2 months.The mean setback of mandible at Po and B point was （7.74 ± 3.93） mm （P〈0.01） and （8.13±3.84） mm （P〈0.01）,and superior movement lengths were （2.73±1.83） mm and （2.76±1.67） mm,respectively.Compared to T2,Po and B point moved forwardly with （2.36±1.23） mm and （2.66±1.65） mm,and inferior movment were （2.16±1.37） mm and （1.21±0.87） mm,respectively.The mean decrease of SNB and GA was （3.74± 1.61）° （P〈 0.01）,（3.41± 1.87）° （P〈0.01）,respectively.During postoperative period,both of them increased,although these were no statistical differences.Conclusions SFA combined postoperative orthodontics therapy is feasible for the correction of adult skeletal class Ⅲ malocclusion,which has shorter treatment duration than traditional joint orthognathic-orthodontic.With the advantages of earlier improvements in patient＇s facial aesthetics and dental function,the reduction in difficulty and treatment duration of orthodontic management,and increasing patient acceptance.

关 键 词：手术优先 正颌外科 错(牙合)畸形 

分 类 号：R783.5[医药卫生—口腔医学]