CAJ | 학술논문

目的探讨骨性双牙弓前突患者经正畸正颌联合治疗后,颌面部硬组织、软组织在矢状方向上的变化及其相互关系,为临床矫治方法的选择提供参考.方法临床选择10例安氏Ⅰ类重度骨性双牙弓前突符合正颌手术的患者,术前正畸矫治完成后实施上、下前颌部截骨后退术(术中去除上下第一前磨牙牙骨块),术后进一步正畸治疗以改善咬合关系.通过手术前后头影测量分析,比较颌面部硬组织,软组织在矢状方向上后退量及其相互关系.结果 10例重度骨性双牙弓前突患者,经正畸-正颌联合矫治后,效果非常显著.上颌切牙平均后退7.13 mm,上颌牙槽骨平均后退6.48 mm,上颌软组织唇突点平均后移5.66 mm.上颌硬、软组织后退的比例为1∶0.87;下颌切牙平均后退6.62 mm,下颌牙槽骨平均后退6.91 mm,下颌软组织唇突点平均后移5.89 mm.硬软组织后移的比值为1∶0.85.结论重度骨性的双牙弓前突患者,应首选正畸正颌联合治疗,可彻底纠正前突的面型,上、下颌的硬软组织显著的内收,达到十分满意的疗效.
목적 탐토골성쌍아궁전돌환자경정기정합연합치료후,합면부경조직、연조직재시상방향상적변화급기상호관계,위림상교치방법적선택제공삼고.방법 림상선택10례안씨Ⅰ류중도골성쌍아궁전돌부합정합수술적환자,술전정기교치완성후실시상、하전합부절골후퇴술(술중거제상하제일전마아아골괴),술후진일보정기치료이개선교합관계.통과수술전후두영측량분석,비교합면부경조직,연조직재시상방향상후퇴량급기상호관계.결과 10례중도골성쌍아궁전돌환자,경정기-정합연합교치후,효과비상현저.상합절아평균후퇴7.13 mm,상합아조골평균후퇴6.48 mm,상합연조직진돌점평균후이5.66 mm.상합경、연조직후퇴적비례위1∶0.87;하합절아평균후퇴6.62 mm,하합아조골평균후퇴6.91 mm,하합연조직진돌점평균후이5.89 mm.경연조직후이적비치위1∶0.85.결론 중도골성적쌍아궁전돌환자,응수선정기정합연합치료,가철저규정전돌적면형,상、하합적경연조직현저적내수,체도십분만의적료효.
Objective To investigate the profile changes and relationship between changes of hard and soft tissues of patients with bimaxillary protrusion corrected by combined surgical and orthodontic treatment.Methods 10 patients with severe bimaxillary protrusion, who needed orthognathic surgery treatment were included in the study.After presurgical orthodontic treatment,anterior maxillary and mandibular subapical osteotomy (to remove the bone around the upper and lower first premolar in the treatment) were performed. Orthodontic treatment was continued to improve the occlusion relationship after surgery. Cephalograms taken before and after combined surgical and orthodontic treatment was analyzed to study the sagittal changes of hard and soft tissues.Results Satisfactory results were obtained after combined surgical and orthodontic treatment.The upper incisors,alveolar jaw and upper lip were retracted with average values of 7.13 mm,6.48 mm and 5.66 mm respectively,and the ratio between hard and soft tissue in upper arch was 1 ∶ 0.87.The lower incisors,alveolar jaw and lower lip were retracted with average values of 6.62 mm,6.91 mm and 5.89 mm respectively,and the ratio between hard and soft tissue in lower arch was 1 ∶ 0.85.Conclusions Combined surgical and orthodontic treatment should be the first choice for patients with severe skeletal bimaxillarv protrusion.Hard and soft tissues were retracted significantly.