下颌优先于双颌正颌手术中运用的研究进展

Research Progress on Mandible-first Sequencing in Bimaxillary Orthognathic Surgery

目前有两种常用的双颌正颌手术顺序:上颌优先和下颌优先。上颌优先即先行上颌骨截骨、定位和固定,再行下颌截骨,通过已固定的上颌定位下颌的位置;下颌优先则反之,以下颌骨的截骨、定位和固定为先,再行上颌手术。有研究发现下颌优先相比上颌优先具有很多优点,但上颌优先和下颌优先的运用范围和术后效果等方面仍存较多争议。本文就下颌优先的运用及其研究进展进行综述,为临床上双颌正颌手术顺序的选择提供参考依据。

Two common sequences of bimaxillary orthognathic surgery are maxillary-first and mandible-first.During maxillary-first sequence,maxilla is repositioned and stabilized firstly,then using the stable maxilla to reposition the mandible.On the contrary,during mandible-first sequence,the mandible is firstly repositioned and stabilized,followed by repositioning the maxilla.Although there were significant advantages to support the using of mandible-first sequence,controversial still remains.The goal of this article is to review the application and research progress of mandible-first to assist surgeons in determining the sequence of bimaxillary orthognathic surgery.