Ⅲ类错[牙合]下颌偏斜正畸疗效的初步分析

Orthodontic treatment of Class 19 patients with mandibular asymmetry

目的探讨Ⅲ类错[牙合]牙性、功能性和轻度骨性下颌偏斜的正畸矫治效果，为临床治疗提供参考。方法选择Ⅲ类错[牙合]牙性、功能性和轻度骨性下颌偏斜患者共35例，男性14例，女性21例，年龄7—22岁（平均16．5岁）。牙性偏斜主要通过扩大上颌牙弓，促使下颌自动复位；功能性下颌偏斜应用双颌式功能矫正器或不对称性前方牵引和Ⅲ类颌间牵引进行治疗；轻度骨性下颌偏斜行拔牙正畸掩饰性治疗。结果通过正畸临床矫治，22例Ⅲ类错[牙合]牙性和功能性下颌偏斜患者的颜面外形和咬合均达到满意的疗效。13例Ⅲ类错[牙合]骨性下颌偏斜患者，拔牙掩饰性正畸矫治仅可改善颜面美观。结论Ⅲ类错袷牙性和功能性下颌偏斜是正畸治疗的适应证；而对于Ⅲ类错[牙合]轻度骨性下颌偏斜的患者，单纯正畸治疗仅可减轻牙袷畸形的程度。

Objective To investigate the treatment outcome of Class Ⅲ patients with dental, functional and mild skeletal mandibular asymmetry. Methods Thirty-five patients （14 males and 21 females） with dental, functional and mild skeletal mandibular asymmetry were selected. The age range of the patients was 7-22 years with a mean age of 16. 5 years. Dental mandibular asymmetry was treated with expansion of maxillary arch to help the mandible returning to normal position. Functional mandibular asymmetry was treated with activator or asymmetrical protraction and Class Ⅲ elastics. Mild skeletal mandibular asymmetry was treated with camouflage treatment. Results Good occlusal relationships were achieved and facial esthetics was greatly improved after orthodontic treatment in patients with dental and functional mandibular asymmetry. However, patients with skeletal mandibular asymmetry should be treated with both extraction and genioplasty. Conclusions Orthodontic treatment was suitable for patients with dental and functional mandibular asymmetry, while combined orthodontics and surgery could get good results in patients with skeletal mandibular asymmetry.