手术优先模式矫治成人严重骨性Ⅲ类错[牙合]畸形

Surgery-first approach in treatment of adult patients with severe skeletal Class Ⅲ malocclusion

手术优先模式(surgery-first,SF)是指正颌手术之前不接受任何使牙齿移动的正畸治疗,或只接受不超过6个月的最小术前正畸准备(minimal orthodontic preparation,MOP)的治疗模式。在传统的术前正畸-正颌手术-术后正畸模式(conventional surgery,CS)中,术前正畸去代偿疗程较长,且常给骨性Ⅲ类患者的面型及咀嚼功能方面带来负面影响,因此,手术优先模式应运而生。然而手术优先模式患者术后咬合状况多不稳定,增加了术后复发的风险。本文旨在对骨性Ⅲ类手术优先模式的发展、优势与局限、适应证、术后稳定性等方面做一简要综述。

The surgery-first(SF)approach is a clinical treatment that proceeds with the orthognathic surgery in the beginning without presurgical orthodontic preparation or with minimal orthodontic preparation(MOP)for less than 6 months.Preoperative orthodontic procedures of conventional orthodontic-orthognathic treatment requires longer pre-surgery time,and patients with skeletal Angle ClassⅢmalocclusion suffer from negative esthetic and functional effects.SF has been proposed to resolve thes erelevant inconveniences.However,compared to conventional treatment,SF approach has a relatively unstable postoperative occlusion which increases the risk of relapse.This article summarizes the history,advantages and disadvantages,indications,and post-operative stability of SF in skeletal Class Ⅲ malocclusion.