骨性安氏Ⅱ类错的外科与正畸联合治疗

Treatment of Skeletal Class Ⅱ Malocclusion by Orthodontic and Surgical Means

目的 :探讨外科与正畸联合治疗骨性安氏Ⅱ类错的方法和特点。方法 :总结分析近年来经外科与正畸联合治疗的骨性安氏Ⅱ类错病例 2 2例 ,介绍典型病例治疗过程 ,着重讨论拔牙时机、术前后正畸治疗特点及术式选择。结果 :本研究 2 2例患者经联合治疗后 ,颌骨关系正常 ,牙弓形态及曲线正常 ,牙排列整齐 ,咬合关系好 ,面形及功能均获明显改善 ,疗效满意。结论 :外科与正畸联合治疗是改正成人骨性安氏Ⅱ类错的有效方法 ,正确的术式选择及合理的正畸治疗是治疗成功的关键。

Objective: Skeletal class Ⅱ malocclusion is often occurred in Oriental and Black. It is difficult to gain the ideal treatment objective either using the orthognathic surgery or orthodontic treatment alone. However, the combined orthodontic and surgical treatment can reach it, so we investigate the methods and characteristics of combined orthodontic and surgical treatment in skeletal class Ⅱ malocclusion. Methods: We analyzed the recent 22 cases with skeletal class Ⅱ malocclusion in Hospital of Stomatology, West China University of Medical Sciences with 7 male and 15 female from 20 to 30 years old. In the study, we discussed the time of extraction, the peculiarity of orthodontic treatment and the selection of surgery type. Results: After the combined orthodontic and surgical treatment, all the patients regained satisfactory face appearance and function. The selection of surgery type is decided by the skeletal characteristics of malocclusion (the malformation degree and the position). The upper first premolars were extracted before the orthodontic treatment for the purpose of better curing of surface of the skeletal wound. And the pre and post surgical orthodontic treatment were very important and necessary to regain the ideal face appearance and function. Conclusion: The combined orthodontic and surgical treatment is an efficient way to cure skeletal class Ⅱ malocclusion. Suitable orthognathic surgery and rational orthodontic treatment are important to treat adult skeletal class Ⅱ malocclusion.