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骨性畸形在牙颌面畸形中占有相当高的比例,许多患者要通过正颌手术治疗。通常患者首诊到正畸科、颌面外科(整形外科、正颌外科)。是否要行正颌手术治疗往往要取决于正畸科是否能通过代偿正畸治疗解决问题。若代偿矫治的结果能使患者和医生都满意,则患者可以避免更复杂、风险更大的正颌手术治疗;若患者的要求很高(可能是美观方面)或畸形非常严重,单纯正畸治疗已不能很好地解决患者对颌面部美观和功能恢复的要求,正颌手术就是惟一正确的选择。目前,在正畸和手术联合治疗开展比较好的医疗单位,是否手术以及手术如何设计几乎是由正畸医生主导。所以,这就要求正畸医生除了要全面掌握骨性牙颌面畸形术前、术后正畸治疗的理论和临床技能外,还要比较透彻地了解各种正颌手术术式、手术的最大限度、术前术后正畸、板制作等方面知识。本文将结合临床实际,就几个正畸和手术联合治疗的重要问题进行讨论,重点在各种畸形正颌手术的术式选择策略,正畸和手术联合治疗的术前、术后正畸治疗原则等。
Bony malformations account for a relatively high proportion of dental and maxillofacial deformities and many patients are treated by orthognathic surgery. Patients are usually first diagnosed orthodontics, maxillofacial surgery (plastic surgery, orthognathic surgery). Orthognathic surgery is often depended on whether orthodontics can solve the problem through compensatory orthodontic treatment. If the result of compensatory correction can satisfy both the patient and the doctor, the patient can avoid the more complicated and risky orthognathic surgery; if the patient’s requirements are very high (may be beautiful) or the deformity is very serious, the orthodontic Treatment has not been able to properly solve the patient’s maxillofacial aesthetic and functional recovery requirements, orthognathic surgery is the only correct choice. At present, orthodontic and surgical combination therapy to carry out better medical units, surgery and how to design the surgery is almost dominated by orthodontists. Therefore, this requires orthodontists in addition to the full grasp of the preoperative and postoperative orthodontic treatment theory and clinical skills, but also a more thorough understanding of a variety of orthognathic surgery, the largest surgical Limit, preoperative and postoperative orthodontic, plate production and other aspects of knowledge. This article will be based on clinical practice, several orthodontic and surgical treatment of important issues discussed, focusing on a variety of orthognathic surgery surgical selection strategy, orthodontic and surgical treatment of preoperative and postoperative orthodontic treatment Principle and so on.