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骨性错畸形需要正畸矫治或者正颌外科联合治疗是毋庸置疑的。某种程度上,颌面外科医生往往认为正颌外科手段是不可或缺的。但是,许多骨性错畸形患者仅凭正畸治疗就获得了可以接受的咬合关系。何种选择是最佳的诊疗方式?其评价标准、优先路径和风险控制是什么呢?特别是边缘性骨性畸形病例,这些均值得深入探讨。本文将在以下几个方面进行简要探讨:正畸与正颌医生的诊疗观念分歧,术前三维诊疗计划的拟定,联合治疗的优先路径遴选,联合治疗中相应合作环节,牵张成骨术(DO)等新进展与早期介入,术后复发认识和术前疗效预测等。事实上,正畸-正颌联合诊疗的范畴相当广泛,无论是否接受正颌手术,知情同意和相关风险告知是必要的,双方紧密合作、支持对于骨性错畸形矫治成功至关重要。
Bone malformation deformity need orthodontic treatment or orthognathic surgery combined treatment is beyond doubt. To some extent, maxillofacial surgeons often believe that orthognathic surgery is indispensable. However, many orthopedic malformation patients achieved an acceptable occlusion relationship only with orthodontic treatment. What kind of choice is the best way of diagnosis and treatment? What are the evaluation criteria, priority path and risk control? Especially the cases of marginal osteal deformity, which are worth discussing in depth. This article will be briefly discussed in the following aspects: Orthodontics and orthognathic doctor concept of disagreement, the preparation of preoperative three-dimensional treatment plan, the joint treatment of the preferred path selection, the corresponding cooperation in joint treatment, distraction osteosynthesis ( DO) and other new progress and early intervention, awareness of recurrence and prognosis of preoperative efficacy prediction. In fact, the scope of orthodontic-orthognathic combination therapy is quite wide. It is necessary to inform informed consent and related risks whether or not receiving orthognathic surgery. Close cooperation and support are crucial for the success of orthodontic treatment of skeletal malformations.