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微型螺钉辅助非手术腭扩张术在前颌骨正颌手术前治疗严重下颌前突患者。

Miniscrew-assisted nonsurgical palatal expansion before orthognathic surgery for a patient with severe mandibular prognathism.

机构信息

Department of Orthodontics, Oral Science Research Center, Institute of Craniofacial Deformity, Yonsei University, Seoul, Korea.

出版信息

Am J Orthod Dentofacial Orthop. 2010 Jun;137(6):830-9. doi: 10.1016/j.ajodo.2007.10.065.

Abstract

A transverse maxillary deficiency in an adult is a challenging problem, especially when it is combined with a severe anteroposterior jaw discrepancy. The demand for nonsurgical maxillary expansion might increase as patients and clinicians try to avoid a 2-stage surgical procedure-surgically assisted rapid palatal expansion followed by orthognathic surgery-and detrimental periodontal effects and relapse. In this regard, a miniscrew-assisted rapid palatal expansion was devised and used to treat a 20-year-old patient who had severe transverse discrepancy and mandibular prognathism. Sufficient maxillary orthopedic expansion with minimal tipping of the buccal segment was achieved preoperatively, and orthognathic surgery corrected the anteroposterior discrepancy. The periodontal soundness and short-term stability of the maxillary expansion were confirmed both clinically and radiologically. Effective incorporation of orthodontic miniscrews for transverse correction might help eliminate the need for some surgical procedures in patients with complex craniofacial discrepancies by securing the safety and stability of the treatment, assuming that the suture is still patent.

摘要

成人的上颌横向发育不足是一个具有挑战性的问题,特别是当它与严重的前后颌骨不调结合时。由于患者和临床医生试图避免 2 阶段手术——手术辅助快速腭扩张,然后是正颌手术,以及有害的牙周效果和复发,对非手术性上颌扩张的需求可能会增加。在这方面,设计并使用了微型螺钉辅助快速腭扩张来治疗一名 20 岁的患者,该患者患有严重的横向差异和下颌前突。术前实现了足够的上颌矫形扩张,颊侧段最小倾斜,正颌手术矫正了前后差异。临床和影像学均证实了上颌扩张的牙周健全性和短期稳定性。通过确保治疗的安全性和稳定性(假设缝合线仍然畅通),有效结合正畸微型螺钉进行横向矫正,可能有助于消除一些具有复杂颅面差异的患者对某些手术的需求。

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