下颌前突畸形的正颌外科矫治

Clinical Study on Orthognathic Surgery for Mandibular Prognathism.

目的 总结正颌外科矫治下颌前突畸形的临床经验。方法 对 32例下颌前突畸形患者进行了正颌外科手术 ,其中 12例行双侧SSRO ,4例行双侧IORO ,10例行双侧IVRO ,5例行上下颌前部根尖下截骨 ,1例行下颌骨体部截骨。同期搭配施行水平截骨颏成形术 12例 ,畸形涉及上颌骨行LeFortⅠ型截骨 9例。结果 32例下颌前突畸形患者术后外观及功能均获得满意效果 ,并发症有术后下颌前突轻度复发 4例 ,明显复发 1例 ,下颌骨升支骨折一侧 1例 ,下牙槽神经一侧断离 1例。结论 随访结果显示应用IVRO、SSRO等术式治疗下颌前突畸形只要术式选择及操作得当 ,能获得较满意效果。文中就手术方法、注意事项及并发症等进行了讨论。

Objective To summerize our experience in orthognathic surgery for treatment of mandibular prognathism. Methods 32 subjects with mandibular prognathism underwent surgery treatment to move the mandibles back. Bilateral sagittal split ramus osteotomy (SSRO) was applied to 12 cases, intraoral vertical ramus osteotomy (IVRO) for 10 cases, and body osteotomy of mandible for one case. Anterior maxillary osteotomy, subapical osteotomy or genioplasty were taken as complement for the cases accompanied with other deformities. Results Most of the subjects reached the results as designed, 5 cases of relapse, 1 mandibular fracture and 1 inferior alveolar nerve injury were observed as the complications. Conclusion The long-term follow-up result shows that SSRO, IVRO etc, if appropriately selected and performed, are good mothods for the correction of mandibular prognathism.