颌面骨骼综合矫治——正颌外科与面部轮廓整形的联合应用与思考  

Comprehensive correction of maxillofacial bone deformity—consideration and combined application of orthognathic surgery and facial contouring surgery

作　　者：祝颂松[1] 李运峰[1] Zhu Songsong;Li Yunfeng(State Key Laboratory of Oral Diseases&National Clinical Research Center for Oral Diseases&Dept.of Orthognathic and Joint Surgery,West China Hospital of Stomatology,Sichuan University,Chengdu 610041,China)

机构地区：[1]口腔疾病研究国家重点实验室国家口腔疾病临床医学研究中心四川大学华西口腔医院正颌与关节外科,成都610041

出　　处：《华西口腔医学杂志》2021年第3期255-259,共5页West China Journal of Stomatology

基　　金：四川省科技厅应用基础项目(2019YJ0103);四川大学研究生教改项目(YJSJG057)。

摘　　要：颌面骨骼是面部外形的基础。临床上,颌面骨骼畸形主要分为同时涉及功能与外形的牙颌面畸形和仅涉及外形的面部轮廓畸形。正颌手术是矫治牙颌面畸形的主要手段,它通过改变颌骨的三维空间位置改变外形,同时改善咬合关系。面部轮廓整形手术主要采用“削骨”的方式,通过截除部分骨组织改变颌骨的“量”实现面部外形改善,一般不涉及功能。在临床上,联合运用正颌手术与面部轮廓整形手术的情况日趋常见。这也要求口腔颌面外科医生具有颌面骨骼矫治的整体思维,将牙颌面畸形与面部轮廓畸形进行综合分析,才能达到最理想的矫治效果。笔者所在团队一直从事牙颌面畸形与面部轮廓畸形的临床工作,在颌面骨骼综合矫治方面积累了较为丰富的临床经验。本文对颌面骨骼综合矫治的适应证、矫治目标、治疗模式、常规治疗方法以及手术操作中的难点问题进行评述。The maxillofacial skeleton is the basis of the contour of the face.Orthognathic surgery and facial contouring surgery change jaw tissue and affect facial appearance in different manners.Orthognathic surgery is the main method to correct dental and maxillofacial deformities.It changes the shape of the jaw and improves the occlusal relationship by changing the three-dimensional position of the jaw.Facial contouring surgery mainly adopts the method of“bone reduction”,which changes the“amount”of the jawbone by cutting a part of the bone tissue to improve the facial appearance,generally without changing oral function.The combined use of orthognathic surgery and facial contouring surgery is becoming increasingly common in clinical practice.This also requires oral and maxillofacial surgeons to have a holistic consideration of the comprehensive correction of maxillofacial bone deformity,and to perform comprehensive analysis of jaw deformities and jaw plastic surgery to achieve the most ideal results.The author's team has been engaged in the clinical work of orthognathic surgery and facial contouring surgery and accumulated rich clinical experience in the comprehensive correction of maxillofacial bone deformity.In this article,the indications,treatment goals,treatment modes,treatment methods,and key points in the surgical operations of comprehensive maxillofacial bone surgery were summarized.

关 键 词：面部轮廓畸形 牙颌面畸形 正颌外科 颌面骨骼 颌骨整形 

分 类 号：R782.2[医药卫生—口腔医学]