【摘要】 目的评价正畸-正颌外科联合治疗唇腭裂伴牙颌畸形的效果。方法回顾分析1990年1月～2000年6月期间在上海第二医科大学和香港大学口腔颌面外科收治的98例唇腭裂伴牙颌面畸形患者,男性52例,女性46例,年龄16～40岁,平均年龄20.5岁。所有患者均在手术前完成正畸治疗,排齐牙列,关闭间隙等。上颌骨手术采用标准化截骨前移手术,伴牙槽裂的患者同期行髂骨取骨植骨术。手术方法包括:①牙槽裂已植骨修复者,采用标准LeFortI型截骨前移术;②牙槽裂未植骨修复的单侧腭裂患者,采用改良上颌骨截骨手术,即非裂侧用LeFortI型截骨术,裂隙侧采用牙槽骨截骨手术(Schuchardt法),同期行牙槽裂植骨术;③牙槽裂未植骨修复的双侧腭裂患者,采用前颌骨截骨手术(Wunderer法)和双侧上颌骨后份牙槽骨截骨手术(Schuchardt法),同期行牙槽裂植骨修复术。骨间采用小钛板坚强内固定。随访时间1/2～5a,平均2.6a。结果术后患者的面型均取得了明显的改善,面部比例协调,咬合关系相对稳定。结论正畸-正颌外科联合治疗唇腭裂伴牙颌面畸形的效果稳定,应该作为这类畸形治疗的常规方法。更多还原

【Abstract】 Objective To evaluate the outcome of joint orthodontics and orthognathic surgery for the tre atment of sec-ondary dentofacial deformity following cleft lip and palate repai r.Methods98patients with secondary dentofacial defor-mity following cleft lip a nd palate repair were retrospectively reviewed since1990.There were52males and46 females,ranging from16to40years in age.All the patients underwent preoperative o rthodontics.Surgical procedures included①standard advancement Le Fort I osteoto my for patients with grafted cleft alveolus,②Le Fort I osteotomy on the non-cle ft side and Schuchardt osteotomy on cleft side,and simultaneously alveolar bone graft for unilateral cleft patients with non-grafted cleft alveolus,③Wunderer o steotomy and bilateral Schuchardt osteotomy,and simultaneously alveolar bone gra ft for bilateral cleft patients with non-grafted cleft alveolus.Rigid fixation w ith miniplates was applied to each patient.The follow-up peroid ranged from6mont hs to5years,with a mean of2.6years.Results It was showed that all the patients h ad a much-improved facial profile,and a satisfactory facial proportion with a re latively stable occlusion.Conclusions The authors recommend that joint orthodont ics and orthognathic surgery with internal rigid fixation should become one of t he routine treatment procedures for secondary dentofacial deformity following cl eft lip and palate repair.更多还原