培训课件--咬合治疗二双语.pptVIP

8976 8976 03-22-2001 正颌外科治疗中的牙合学问题The occlusion problems in orthognathic surgery 与颞下颌关节关系密切的正颌外科术式The most relative surgery methods 1.上颌Le FortI型截骨术 Maxillary LeFortI osteotomy 2. 下颌升支切开术 Mandibular ramus osteotomy (1)双侧下颌升支矢状劈开术(BSSO) Bilateral sagital split osteotomy (2)下颌升支斜行或垂直骨切开术 Oblique or vertical ramus osteotomy 下颌升支切开术 Mandibular ramus osteotomy 正颌手术与TMD之间的相互作用 Interaction between operation and TMD 两种观点 1.手术有时会加重关节症状，造成髁突移位与吸收。 2.手术对TMD的治疗作用：建立适宜的上下颌关系。 Two opinions TMD symptom will be aggravated after operation because of the pre-positioned and absorbtion of condyle. TMD symptom will be improved by the operation: establishing appropriate relationship of the upper and lower jaws. 正颌外科治疗对髁突位置的影响Influences on TMJ 髁突位置改变 (1) 全麻状态 (2) 手术方式 (3) 固定方式 The altered location of condyle General anesthesia Operation mode Fixed mode 牙合关系改变 Occlusal relationship changes 手术创伤　 Surgery trauma TMJ 对手术的影响Effects on the operation 手术对关节造成的改变反过来又能影响手术效果导致复发。 通过影响髁突的位置或髁突吸收及骨段间移动导致复发。 The TMJ alterations can effect the operation as well and finally cause recurrence . Recurrence is caused by the alterations or the absorbtion of condyle. 正畸治疗TMDTMD cured by orthodontic treatment 颞下颌关节紊乱的病因Etiology 牙合因素： 磨牙、紧咬牙 肌肉因素 精神心理因素 Occlusal factors: grinding, clenching Masticatory muscles factors Emotional factors 1. 掌握适应证 必须是由错牙合畸形引起的颞颌关节问题。 Mastering indications The TMD must be caused by malocclusion. 正畸治疗TMD的特点 2. 明确针对病因及机制进行治疗Treatment according to pathogenies and mechanisms  颞下颌关节紊乱病患者 去除病因。 内倾型深覆牙合型 解除锁结。 个别牙错位 解除 牙合干扰。 肌功能紊乱患者 配合理疗等手段。 TMD patients eliminating pathogeny. Palatal inclination and deep overbite Eliminating locked occlusion. Individual malposed tooth eliminating occlusal interference. Myofunctional disorder patients applying with physical therapy and so on. 3. 美观与功能统一 The