Squire Douglas, Best Al M, Lindauer Steven J, Laskin Daniel M
Department of Biostatistics, Virginia Commonwealth University School of Medicine, Richmond, Va 23298-0565, USA.
Am J Orthod Dentofacial Orthop. 2006 Jun;129(6):804-8. doi: 10.1016/j.ajodo.2006.02.003.
Because of the severity of some malocclusions, it is not always possible to treat them without a combination of orthodontics and orthognathic surgery. However, many insurance carriers have difficulty in deciding whether such treatment should be covered. The purpose of this study was to develop a simple method that can be used by insurance carriers to determine when a malocclusion is not correctable by orthodontics alone.
Twenty-eight orthodontists independently evaluated 30 sets of pretreatment dental models (10 with overjet from -6 to 12 mm, 10 with overbite from 60% to 100%, and 10 with transverse discrepancies from single tooth to total arch crossbite) to determine whether the conditions were orthodontically treatable. They were instructed to assume that growth was complete and that the treatment would not seriously compromise facial esthetics.
It was the opinion of the orthodontists that a positive overjet greater than 8 mm, a negative overjet of -4 mm or greater, and a transverse discrepancy greater than 3 mm were not orthodontically treatable. However, most orthodontists believed that they could treat all overbite patients without surgery.
These data can serve as a simple guideline for helping insurance carriers determine the need for orthognathic surgery.
由于某些错牙合畸形的严重性，若不结合正畸治疗和正颌外科手术，往往无法对其进行治疗。然而，许多保险公司在决定是否承保此类治疗时存在困难。本研究的目的是开发一种简单的方法，可供保险公司用于确定何时错牙合畸形无法仅通过正畸治疗得以矫正。
28位正畸医生独立评估了30套治疗前的牙齿模型（10套覆盖超牙合为-6至12毫米，10套覆牙合为60%至100%，10套横向差异为单颗牙齿至全牙弓反牙合），以确定这些情况是否可通过正畸治疗。他们被要求假设生长已完成，且治疗不会严重损害面部美观。
正畸医生们认为，覆盖超牙合大于8毫米、覆盖超牙合为-4毫米或更大以及横向差异大于3毫米的情况无法通过正畸治疗。然而，大多数正畸医生认为他们可以在不进行手术的情况下治疗所有覆牙合患者。
这些数据可作为一个简单的指导方针，帮助保险公司确定是否需要正颌外科手术。
