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目的:通过头影测量分析研究经正畸正颌联合治疗的骨性Ⅲ类错畸形在治疗前和经术前正畸后手术前骨性和牙性的垂直向、矢状向变化及牙齿去代偿情况,分析总结骨性Ⅲ类错畸形的术前正畸治疗特点。方法:回顾性研究正畸正颌联合治疗包括行完善的术前正畸的骨性Ⅲ类患者25例,治疗前根据临床检查、头影测量分析和模型分析等与正颌外科医生会诊制定治疗计划。经过术前正畸、正颌手术和术后正畸观察患者疗效。结果:大多数患者的术前正畸为非拔牙矫治,少数为拔上颌双尖牙和因龋坏等原因拔除其他部位的牙齿。经过术前正畸去代偿治疗,骨性方面垂直向和矢状向的关系均无变化。在牙性方面大多数上前牙代偿情况没有明显变化,而下前牙去代偿比较完善,有显著统计学意义(P<0.05)。结论:骨性Ⅲ类错畸形术前正畸可以去除大部分下颌前牙代偿,但是上前牙去代偿效果不明显。虽然患者对治疗效果满意,但术前正畸并未达到完全去代偿。能否完全去除代偿及有无必要完全去除代偿,仍值得进一步探讨和研究。
OBJECTIVE: To study the vertical and sagittal changes of skeletal and dental properties of skeletal class Ⅲ malocclusion treated by orthodontics and orthognathic surgery before and after orthodontics To compensate for the situation, analyze and summarize the characteristics of skeletal Class Ⅲ malocclusion preoperative orthodontic treatment. Methods: Retrospective study of orthodontic and orthognathic combined treatment of 25 cases of complete orthodontic skeletal Class Ⅲ patients before treatment according to clinical examination, cephalometric analysis and model analysis and orthopedic surgeon consultation treatment plan. After orthodontics, orthognathic surgery and postoperative orthodontic observation of patients. Results: Most of the patients had preoperative orthodontics as non-extraction treatment. A few of them were those with maxillary bicuspids and those with other parts removed due to caries. After preoperative orthodontic treatment, there was no change in the relationship between vertical and sagittal orientation. In the aspect of dentistry, most of the anterior teeth did not have any significant changes in compensatory status, while the lower anterior teeth compensated quite well, with significant statistical significance (P <0.05). Conclusions: Preoperative orthodontics of skeletal Class Ⅲ malocclusion can remove most of the mandibular anterior teeth compensation, but the anterior teeth compensation effect is not obvious. Although patients were satisfied with the treatment, orthodontics did not completely compensate before surgery. Whether we can completely remove the compensation and whether it is necessary to completely remove the compensation is still worth further exploration and research.