骨性Ⅲ类错伴下颌偏斜正颌外科的术前术后正畸治疗

The orthodontic treatment of pre-and post-operation on skeletal Class Ⅲ malocclusion accompanied with mandibular asymmetry

目的:分析、总结临床采用正畸——正颌外科方法联合治疗骨性Ⅲ类错伴下颌偏斜畸形时术前与术后正畸治疗中的难点和要点,为临床工作提供参考。方法:采用方丝弓或直丝弓技术,对本组患者均进行了系统的术前术后正畸治疗,术前根据X线头影测量、模型外科制作!板,术中截骨后根据板后退旋转下颌骨,用微型钛板固定下颌骨,使上下颌颌骨处于术前设计好的咬合状态,增加术后!关系的稳定性,使术后牙齿咬合于理想的位置。结果:术前正畸疗程为4～13个月,平均10个月。术后正畸疗程为7～23个月,平均12个月,术后咬合关系良好,均达到个别正常。面部软组织左右对称,侧面由凹面型变为垂直面型,面型改善明显,患者满意。结论:术前术后正畸治疗是正颌外科治疗骨性反伴下颌偏斜畸形取得良好效果的必要保证。

Objective： To analyze the orthodontic treatment of mandibular asymmetry and prognathism, on pre-and post-surgical operation and summarize some helpful experiences for future clinical work. Methods： All patients were treated with edgewise or straight wise appliance on pre-and post-operation. We made interocclusal splint according to the X-ray cephalometric and model surgery before orthognathic surgery. Mandibular was rotated backward and downward according to splint by osteotomy, and fixed by miniplant in order to locate the jaws at the position which was designed before surgery, increase the stabilization of occlusal relationships and remaine teeth in the ideal position on post-operation. Results： The duration of orthodontic treatment of pre-and post-surgical operation was 4~13 months（mean 10 months）and 7~23 months（mean 12 months） respectively.The results achieved at individual normal occlusion, symmetry in soft tissue and vertical facial type. The patients all satisfied with the obvious improvement of facial type. Conclusion： Orthodontic treatment of pre-and post-surgical operation is essential for the orthognathic