Ho Cheng Ting, Heller Frank, Lo Lun-Jou, Liou Eric J W, Huang C Shing, Chen Yu-Ray
Department of Orthodontics, Chang Gung Memorial Hospital, Kwei Shan, Taoyuan, Taiwan.
Plast Reconstr Surg. 2006 Jun;117(7):2337-46. doi: 10.1097/01.prs.0000218785.34959.4c.
In this study, the authors evaluated the long-term results after using anterior segmental osteotomy and distraction osteogenesis for the correction of sagittal maxillary deficiency associated with dental crowding.
Six young adolescents (four boys and two girls) underwent surgery and distraction at a mean age of 11.2 years (range, 10 to 12 years) and were followed up for 3 years. A tooth-borne distraction device was used for interdental distraction. The evaluation consisted of hard- and soft-tissue profile analysis and dental arch measurements before, immediately after, and 3 years after distraction.
The results showed that the facial profile, the occlusion, and the dental crowding could be successfully corrected and that the results were stable after 3 years' follow-up. The mean facial convexity angle was changed from 1 to 8 degrees. The average advancement at point A was 4 mm and the SNA increased by an average of 4 degrees. Lengthening of the dental arch by an average of 4 mm created approximately 8 mm of new space, sufficient to resolve the dental crowding in all patients, thus avoiding an extraction of healthy teeth.
The results of this study demonstrated that anterior segmental maxillary osteotomy combined with distraction osteogenesis offers an alternative for the treatment of adolescents suffering from sagittal maxillary deficiency with dental crowding.
在本研究中，作者评估了采用上颌前部节段性截骨术和牵张成骨术矫正与牙列拥挤相关的上颌矢状向发育不足后的长期效果。
6名青少年（4名男孩和2名女孩）平均在11.2岁（范围10至12岁）时接受手术和牵张，并随访3年。使用牙支持式牵张装置进行牙间牵张。评估包括在牵张前、牵张后即刻和牵张后3年进行硬组织和软组织侧貌分析以及牙弓测量。
结果显示，面部侧貌、咬合关系和牙列拥挤均得到成功矫正，且随访3年后效果稳定。平均面部凸度角从1度变为8度。A点平均前移4mm，SNA平均增加4度。牙弓平均延长4mm，产生了约8mm的新间隙，足以解决所有患者的牙列拥挤问题，从而避免了拔除健康牙齿。
本研究结果表明，上颌前部节段性截骨术联合牵张成骨术为治疗患有上颌矢状向发育不足伴牙列拥挤的青少年提供了一种替代方法。
