发育性下颌骨不对称畸形-正颌外科治疗探讨.docVIP

发育性下颌骨不对称畸形的 正颌外科治疗探讨 来源：青年人(Qnr.Cn) 更新时间：2010-3-23 17:13:21 【字体：HYPERLINK javascript:fontZoomA();小 HYPERLINK javascript:fontZoomB();大】 【摘要】　目的　探讨通过正颌手段治疗发育性下颌骨不对称畸形，以获得良好的口腔功能 和面部外形并防止复发的方法。方法　对我科1990年以来所收治的37例发育性下颌骨不对称畸形的类型、 诊断方法、治疗手段及疗效进行回顾性总结。结果　根据不同的类型采用相应的处理方法，均获得满意的疗效，术后皆 获得良好的口腔咬合功能和面部外形。结论　发育性下颌骨不对称畸形的正颌外科治疗，在完善面部外形时，术 前正畸可保证术后良好的口腔咬合功能；术前应确诊下颌骨不对称的畸形发育业已停止抑或 尚在继续增生发展；骨畸形的矫正与软组织的矫正尽可能分次进行。　　【关键词】　下颌骨　不对称畸形　正颌外科 The orthognathic treatment of developmental mandibular asymme try GAO Yiming　QIU Weiliu　TANG Yousheng　et al（Department of Oral and Maxillofacial Surgery,The Stomatology School, Shanghai,Th e Second Medical University, Shanghai 200011, PR China） 　　【Abstract】　Objective　To explore the methods of orthognathic treatment for the developmental mandibular asymmetry to simultaneously achieve s atisfactory facial appearance and oral functions and to prevent recurrence of th e deformity. Methods　37 cases of developmental mandibular asymmetry have bee n treated in past seven years. The type of the deformity,the management of the c ases,and the effects of therapy were summarized in this paper. Results　According to the type of the asymmetric deformity,diffe rent means were used. After treatment,all the patients obtained satisfactory fac ial appearance and oral function. Conclusions　During the orthognathic treatment,it is important t o simultaneously ameliorate facial appearance and achieve good oral function. It should be diagnosed before surgery whether the development of the deformity is steady or not. The correction of skeleton and soft tissues must be performed by stages.　　【Key words】　Mandible；　Asymmetry；　Orthognathic 　　在所有的颜面不对称畸形中以下颌骨不对称畸形最为常见［1，2］，然而对于颜面不对称畸形精确的诊断标准目前尚无定论［1，3-5］。下颌骨不对称畸形的矫治除下颌骨的矫正外还涉及到上颌骨畸形、软组织畸形的矫正、正常咬合关系恢复、颞下颌关节功能的保护等，如何正确处理上述问题及其相互关系，以获得满意的整形效果、良好的口腔咬合功能及预防复发，尚存在许多不同的看法。我们通过对1990年以来我科所收治的37例发育性下颌骨不对称畸形(其中不包括第一、二鳃弓综合征、颞颌关节强直及颜面萎缩等)的诊断、手术方法及治疗效果进行了总结，以探讨下颌骨畸形合理的处理方法。 1　临床资料与治疗方法 1.1　一般资料　　本组共37例，其中男性15例，最大年龄38岁，最小18岁；女性22例，最大年龄40岁，最小1