CAJ | 학술논문

目的：探讨在正颌外科手术中同期完成下颌骨的塑型手术、上颌骨前壁骨移植或Medpor植入术的可行性。方法：18例女性患者，平均年龄23岁。均诊断为牙颌面畸形，其中下颌前突或伴下颌骨偏斜畸形13例，双颌前突畸形2例，上颌后缩伴下颌前突畸形3例。对上述病例进行正颌外科手术的同时行下颌骨的塑型和（或）上颌骨的骨移植或Medpor植入术、颏成型术。结果：所有病例在术后均出现下唇的麻木，但术后1～6个月下唇感觉恢复正常。无牙齿损伤、伤口感染和骨段坏死发生。经过6～23个月的正畸治疗，均获得良好的咬合关系和协调的面部比例关系及满意的面部轮廓。术后6个月～3年影像检查评估结果表明骨移植成活良好，较少出现骨吸收的现象。结论：在正颌手术的同时进行下颌骨的塑型和（或）上颌骨骨移植或Medpor植入术是可行的，可增加术后面部的美学效果和患者的满意度，同时不增加手术并发症。下颌骨截除的骨质可以用于正颌手术中，避免了其他部位的取骨。
목적：탐토재정합외과수술중동기완성하합골적소형수술、상합골전벽골이식혹Medpor식입술적가행성。방법：18례녀성환자，평균년령23세。균진단위아합면기형，기중하합전돌혹반하합골편사기형13례，쌍합전돌기형2례，상합후축반하합전돌기형3례。대상술병례진행정합외과수술적동시행하합골적소형화（혹）상합골적골이식혹Medpor식입술、해성형술。결과：소유병례재술후균출현하진적마목，단술후1～6개월하진감각회복정상。무아치손상、상구감염화골단배사발생。경과6～23개월적정기치료，균획득량호적교합관계화협조적면부비례관계급만의적면부륜곽。술후6개월～3년영상검사평고결과표명골이식성활량호，교소출현골흡수적현상。결론：재정합수술적동시진행하합골적소형화（혹）상합골골이식혹Medpor식입술시가행적，가증가술후면부적미학효과화환자적만의도，동시불증가수술병발증。하합골절제적골질가이용우정합수술중，피면료기타부위적취골。
Objective:To explore the feasibility of mandibuloplastic surgery or augmentation on the maxilla with autologous bone or Medpor during the orthognathic surgery . Methods: In this series , 18 consecutive patients (females, average age 23) with dentofacial deformities ,were underwent orthognathic surgeries and mandibuloplasti -es, or augmentation on the maxilla with autologous bone or Medpor .Dentofacial deformities were classified as mandi-ble prognathism ( or complicated by mandible deviation ) with classⅢmalocclusions in 13, bimaxillary protusion in 2, maxilla retrusion and mandible prognathism in 3.Results:All patients showed normal sensibility of the lower lip after a 6-month postoperative follow-up, that indicated that inferior alveolar nerve functional was not be affected perpetually.Teeth injury,infection or bone segment necrosis didn′t occur in this series.Normal occlusions were established after the postoperative 6 to 23-month orthodontic treatment in the all patients .Harmonious and attractive facial contours are achieved in the all patients .The grafted bone present less bone resorption in some patients by radiographic assessment after from 6-month to 3-year surgery .Conclusion:The study shows that mandibuloplasty or /and augmentation on the maxilla can be safely performed at the time of orthog-nathic surgery ,and improve the results and the patient′s satisfaction .Moreover , this additional surgeries don′t increase the complication rate .Osseous tissue from mandibuloplastic surgery can be used as bone grafting for orthognathic surgery and it avoids the harvesting bone from other parts .