Johnston Chris, Burden Donald, Kennedy David, Harradine Nigel, Stevenson Mike
Orthodontic Division, Oral Healthcare Research Centre, School of Clinical Dentistry, Queen's University Belfast, Belfast, Northern Ireland, United Kingdom.
Am J Orthod Dentofacial Orthop. 2006 Sep;130(3):300-9. doi: 10.1016/j.ajodo.2005.01.023.
In this retrospective study, we investigated treatment outcomes in Class III surgical-orthodontic patients.
Records of 151 consecutively completed Class III surgical-orthodontic patients (overjet, 0 mm or less) were obtained from 87 consultant orthodontists in the United Kingdom. Pretreatment and posttreatment cephalometric radiographs were analyzed.
Bimaxillary surgical patients (75%) had more negative initial ANB-angle values and smaller initial SNA-angle values than those treated with single-jaw mandibular surgery. Mandibular surgery patients (15%) had greater pretreatment mandibular prominence (SNB angle) than maxillary patients. Maxilla-only patients (10%) had lower negative initial overjet values than bimaxillary patients. An overjet within the ideal range of 1 to 4 mm was achieved in 83% of the patients. Logistic regression identified no predictors of ideal overjet outcome. SNB angle was corrected to within the ideal range of 75 degrees to 81 degrees in 44% of the patients. This was less likely in those treated with maxillary surgery only and larger initial SNB-angle values. An ideal posttreatment ANB angle (1 degrees to 5 degrees) was achieved in 40% of the patients and was more likely in those with bimaxillary surgery, lower negative pretreatment ANB angles, and presurgical orthodontic extractions in the maxillary arch. Ideal posttreatment unadjusted Holdaway angles (7 degrees to 14 degrees) were achieved in 59% of the patients and were more likely when single-jaw mandibular surgery was used. Incisor decompensation was incomplete in 46% of the patients and was associated with mandibular arch extractions.
Surgical-orthodontic treatment had a high success rate in normalizing the overjet and soft-tissue profile to within ideal ranges in Class III patients. Bimaxillary surgery was the most frequently used procedure and was associated with an increased likelihood of an ideal correction of the anteroposterior skeletal discrepancy.
在这项回顾性研究中，我们调查了III类外科正畸患者的治疗结果。
从英国87位正畸顾问医生处获取了151例连续完成治疗的III类外科正畸患者（覆盖，0毫米或更小）的记录。对治疗前和治疗后的头影测量X线片进行分析。
双颌手术患者（75%）的初始ANB角负值比单颌下颌手术患者更大，初始SNA角值更小。下颌手术患者（15%）治疗前的下颌前突（SNB角）比上颌手术患者更大。仅上颌手术患者（10%）的初始覆盖负值比双颌手术患者更低。83%的患者实现了1至4毫米理想范围内的覆盖。逻辑回归分析未发现理想覆盖结果的预测因素。44%的患者SNB角被矫正至75度至81度的理想范围内。仅接受上颌手术且初始SNB角值较大的患者实现这一目标的可能性较小。40%的患者实现了理想的治疗后ANB角（1度至5度），双颌手术、治疗前ANB角负值较低以及上颌弓进行术前正畸拔牙的患者更易实现。59%的患者实现了理想的治疗后未调整的霍尔德沃思角（7度至14度），采用单颌下颌手术时更易实现。46%的患者切牙去代偿不完全，这与下颌弓拔牙有关。
外科正畸治疗在将III类患者的覆盖和软组织侧貌恢复至理想范围方面成功率较高。双颌手术是最常用的术式，且与前后骨骼差异理想矫正的可能性增加相关。
