正畸-正颌联合治疗中上颌骨性宽度不足治疗方法的研究进展

Research progress in the treatment of maxillary transverse deficiency with combined orthodontic-orthognathic approach

正畸-正颌联合治疗中上颌骨性宽度不足患者的上颌骨腭中缝多已闭合,单纯牙性扩弓及快速扩弓无法达到骨性扩宽,而是更多实现牙齿倾斜,导致疗效不稳定。因此,临床常采用正颌术中节段性LeFortⅠ型截骨术、外科辅助上颌快速扩弓实现腭中缝扩展,近年随着种植体支抗技术的广泛应用,种植体支抗辅助快速扩弓逐渐应用于正畸-正颌联合治疗中。本文通过对正颌术中节段性LeFortⅠ型截骨术、外科辅助上颌快速扩弓、种植体支抗辅助快速扩弓3种术式的适应证、禁忌证、并发症、疗效及其长期稳定性的研究现状进行综述,为临床治疗方案的选择提供参考。

In combined orthodontic-orthognathic treatment,the maxillary palatine suture is closed in most patients with insufficient maxillary width,and bony expansion of the maxilla cannot be achieved by dental expansion or rapid palatal expansion(RPE)which causes buccal inclination of the maxillary posterior teeth leading to unstable results.Therefore,segmental LeFortⅠosteotomy and surgically assisted RPE are often used in clinical practice.In recent years,with the application of implant anchorage technology,implant anchorage assisted RPE has been gradually applied in orthognathic treatment.This article reviewed the indications,contraindications,complications,efficacy and long-term stability in different treatment approaches including segmental LeFortⅠosteotomy,surgically assisted RPE and implant-supported maxillary skeletal expansion.