双颌前部根尖下截骨术对双颌前突畸形患者咬合关系的影响

摘要

目的 研究双颌前部根尖下截骨术对双颌前突畸形患者咬合关系的影响.方法 选择2003年9月～2014年10月中国医学科学院整形外科医院收治的20例双颌前突患者,均接受同期上颌及下颌前部根尖下截骨手术.通过对患者术前及术后进行头影测量,系统地分析此术式对患者咬合关系的影响.结果 与治疗前相比,患者治疗后的头影测量上切牙牙轴倾斜度(U1-OP)、下切牙牙轴倾斜度(L1-OP)、下中切牙牙轴-下颌平面角(IMPA)、上中切牙突距(U1E-Apog)、下中切牙突距(L1E-Apog)、上中切牙-NA的垂距(U1E-NA)、下牙倾斜度(L1-NB)、下中切牙-NB的垂距(L1E-NB)有所减小,上下中切牙角(ⅡA)、上牙倾斜度(U1-NA)有所增加,差异有高度统计学意义(P＜0.01).结论 通过术前模型外科设计,可以确定一部分双颌前突的患者仅需要正颌手术即可同期矫正,明显提高治疗效率,减轻患者经济和身体负担,值得进一步深入研究以进一步普及和推广.%Objective To study effect of anterior apical osteotomy on occlusal relationship in patients with bimaxillary protrusion.Methods From September 2003 to October 2014,20 patients with bimaxillary protrusion were included in this study,who underwent anterior subapical osteotomy of both the maxilla and mandible in Plastic Surgery Hospital,Chinese Academy of Medical Sciences.In addition,the pre-and postoperative cephalometric radiographs were systematically analyzed.Results After surgery,the levels of U1-OP,L1-OP,IMPA,U1E-Apog,L1E-Apog,U1E-NA,L1-NB,L1E-NB were decreased than before surgery,and the levels of Ⅱ A and U1-NA were increased than before surgery,with high statistically significant difference (P ＜ 0.01).Conclusion With the use of a precise preoperative model surgical design,orthognathic surgery,a simple and time-saving technique,can be used to correct bimaxillary protrusion with satisfactory postoperative occlusal relationship,and minimal postoperative complications.