摘要
目的 通过对青少年上颌骨严重发育不足 ,特别是继发于唇腭裂术后严重畸形者行改良LeFortI型截骨 ,并通过颅骨外固定上颌骨牵引成骨前移术 ,对牵引成骨后硬组织改建及腭咽闭合功能进行初步探讨。方法 采用颅骨外固定牵引装置 (KLS MARTIN公司提供 )对 6例 11～ 15岁唇腭裂术后继发上颌骨严重发育不足及发育性上颌骨严重后缩畸形的青少年实施牵引成骨术。运用正颌外科电脑分析软件对术前、术后头颅定位X线侧位片行颅颌面硬组织的测量分析。结果 6例青少年上颌骨牵引前移 8～ 13mm ,平均为 10 .2mm。SNA角度分别增大 7～ 10 .5°,平均为 9°。头颅侧位片可显示翼上颌裂区新骨形成。面部外形得到明显改善 ,咬合关系调整至远中关系。结论 应用牵引成骨技术早期解除上颌骨发育不足畸形 ,避免或减轻口颌系统继发畸形和功能障碍 ,同时避免骨移植 ,稳定治疗效果。
Objective To demonstrate a practical method for advancement of the midface using Le FortⅠ osteotomy and gradual distraction technique. Methods With the use of an external adjustable, rigid distraction device, we treated 6 patients with severe maxillary hypoplasia. Ages ranged from 11 to 15 years. They all underwent modified Le FortⅠosteotomies assisted by gradual distraction. Four days postoperatively, distraction began at the rate of 1 mm/day for about 2 weeks. 4 weeks with the fixed distraction appliance and 6 weeks with a removable night time face mask retention, we then analyzed all those preoperative and postoperative protocols. Results Predictable results were obtained. Midface advancement ranged from 8 to 13 mm. A satisfactory classⅠor Ⅱmolar relationship is achieved. The aesthetic results are excellent. Up to now, no relapses have been observed. Conclusions This method of modified Le FortⅠmidface advancement has been shown to be clinically practical and effective.
出处
《中华口腔医学杂志》
CAS
CSCD
北大核心
2000年第6期434-436,I033,共4页
Chinese Journal of Stomatology
关键词
上颌骨
口颌系统畸形
牵引术
Maxilla
Stomatology system abnormalities
Traction
