【摘要】 目的介绍采用以双颌正颌外科为主的综合技术矫正颌面偏斜的经验和技巧。方法过去10年间采用以双颌正颌外科为主的综合技术矫治颌面偏斜12例。主要术式是Le FortⅠ行截骨+下颌支矢状劈开+颏成形术,选择性结合牵引成骨和快速成形技术。根据下颌支手术是在双侧进行或在单侧进行将患者分为2组,每组6例。结果两组病例术中术后经过顺利,在出血量和并发症方面没有差别。经8个月~2年随访,9例临床效果稳定,面形基本对称,面高度比例和谐,张口度均大于35 mm。特别介绍了采用计算机虚拟外科和快速成形技术制作硬组织植入体的优点。1组有2例,2组有1例存在明显的复发倾向,可以用术后正畸控制。结论双颌正颌外科+颏成形技术结合快速成形技术矫正颌面偏斜是未来的发展方向,同期手术解决软组织增容问题将进一步提高临床疗效。更多还原

【Abstract】 Objective This paper presents the experiences and techniques of bimaxillary orthognathic surgery in treatment of dental-facial oblique deformities.Methods In past decade,12 patients with dental-facial oblique deformities were treated in this center.The main techniques consisted of Le Fort I osteotomy and sagittal split ramus osteotomy combined with genioplasty.Alternative technique included distraction osteogenesis and rapid prototyping.The patients were divided into 2 groups.beach.according to the ramus procedure performed ether bilaterally or unilaterally.Results The operation and healing were uneventful.During the follow-up for 8 months to 2 years,stable results were found in 9 patients with symmetrical face,normal proportion of facial height,and mouth openning of more than 35 mm.The advantages of computer-assisted mimic surgery and manufacture of implant for hard tissue by rapid prototyping technique are specially presented.Apparent tendency of relapse was found in two cases in group 1 and one case in group 2,which could be controlled by orthodontic treatment.Futher study is needed to correct the deficiency of soft tissue in the face.Conclusions For correction of dental-facial oblique deformity,clinical result can be expected by combination of bimaxillary orthognathic surgery and genioplasy with rapid prototyping technique in future.Further improvement can be expected if the soft tissue can be augmented simultaneously.更多还原