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成年青少年患者的上颌骨皮质切开术与口外正畸牵引:病例报告

Maxillary corticotomy and extraoral orthopedic traction in mature teenage patients: a case report.

作者信息

Pelo Sandro, Boniello Roberto, Gasparini Giulio, Longobardi Gianluigi

机构信息

Department of Oral and Maxillofacial Surgery, Università Cattolica del Sacro Cuore Policlinico A. Gemelli, Rome, Italy.

出版信息

J Contemp Dent Pract. 2007 Jul 1;8(5):76-84.

Abstract

AIM

The authors' propose to combine the reverse pull headgear with a Delaire type face mask and a maxillary corticotomy to treat a Class III non-growing patient with maxillary retrusion. The aim of this report is to present two cases in which this treatment strategy was successful.

BACKGROUND

Several studies suggest the majority of Class III dento-skeletal malocclusions have components of maxillary retrusion. Early treatment of these patients with maxillary protraction devices have shown promising results. Facemask therapy has some important limits. Most important is the optimal timing of treatment between the ages of six to ten years. Closure of the maxillary suture occurs as a child ages which results in an increase of maxillary resistance to protraction.

REPORT

A proposed therapy carried out in orthodontic and surgical phases was used in the treatment of two young patients. They were both beyond the optimal age range for the application of the orthopedic device (a girl 15 years old and a boy 16 years old), however, they had not reached the necessary skeletal maturity for orthognathic surgery.

SUMMARY

The described technique has the advantage of being quick and easy to perform with a low surgical risk yielding satisfactory results after 15-20 days of therapy instead of the six to nine months associated with traditional procedures.

摘要

目的

作者建议将反向牵引头帽与德莱尔式面罩及上颌骨皮质切开术相结合,以治疗一名上颌后缩的恒牙期Ⅲ类错颌患者。本报告旨在展示两例采用该治疗策略取得成功的病例。

背景

多项研究表明,大多数Ⅲ类牙颌面畸形都伴有上颌后缩成分。早期使用上颌前牵引装置治疗这些患者已显示出有前景的结果。面罩治疗存在一些重要局限性。最重要的是治疗的最佳时机在6至10岁之间。随着儿童年龄增长,上颌缝会闭合,这会导致上颌对前牵引的阻力增加。

报告

在两名年轻患者的治疗中采用了一种在正畸和手术阶段实施的建议疗法。他们都超出了使用矫形装置的最佳年龄范围(一名15岁女孩和一名16岁男孩),然而,他们尚未达到正颌手术所需的骨骼成熟度。

总结

所描述的技术具有操作快速简便、手术风险低的优点,治疗15至20天后即可取得满意效果,而传统方法则需要6至9个月。

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