正畸正颌联合治疗唇腭裂继发牙颌面畸形

Combined Orthodontic Treatment and Orthognathic Surgery for Correct of Patients of Cleft Lip and Palate with Secondary Dentofacial Deformity

目的评价正畸正颌联合治疗唇腭裂继发牙颌面畸形的疗效。方法回顾性研究2000年7月～2005年9月广东省口腔医院治疗的20例唇腭裂继发牙颌面畸形患者。20例患者均行术前及术后正畸治疗,单纯采用上颌骨LeFortⅠ型截骨前移者1例,单纯采用双侧下颌升支矢状劈开后退术者1例,行LeFortⅠ型截骨前移术+双侧下颌升支矢状劈开后退术者15例,行LeFortⅠ型截骨前移术+双侧下颌升支矢状劈开后退术+颏成型术者3例。17例患者在正颌手术前行牙槽裂植骨。结果经治疗患者上颌前移(5.5±1.2)mm,下颌后退(7.2±2.5)mm。患者唇颏关系改善明显,咬合关系良好,但大部分患者鼻部仍有塌陷及偏斜畸形。患者术前后语音状况经语音师评估均无明显变化。结论正畸正颌联合治疗唇腭裂继发牙颌面畸形,可以较好地改善患者的容貌并取得良好的咬合关系。

Objective To evaluate the outcome of cleft lip and palate patients with secondary dentofacial deformity corrected by orthodontics and orthognathic surgery. Methods Twenty patients with secondary dentofacial deformity from Guangdong Provincial Stomatological Hospital since 2000 were retrospectively reviewed. All the patients underwent pre and post-operative orthodontics. The surgical procedures of these 50 cases were as followed： Le Fort Ⅰ osteotomy in 1 case, bilateral sagittal split ramus osteotomy in 1 case, Le Fort Ⅰ osteotomy and bilateral sagittal split ramus osteotomy in 15 cases, Le Fort Ⅰ osteotomy combined with bilateral sagittal split ramus osteotomy and genioplasty in 3 cases. 17 patients underwent alveolar bone graft before orthognathic surgery, Results It showed that all the patients had a much-improved facial profile and satisfactory occlusion. Conclusion Cleft lip and palate patients following secondary dentofacial deformity corrected by orthodontics and orthognathic surgery may get satisfactory outcome.