Nassif Laeticia, Anhoury Patrick, Chebel Naji Abou
Division of Orthodontics and Dentofacial Orthopedics, American University of Beirut Medical Center, Beirut, Lebanon.
World J Orthod. 2010 Winter;11(4):e114-24.
The present article illustrates a treatment option for managing the skeletal Class II malocclusion complicated by a deep bite and short face in an adult and emphasizes the limitations of such an approach and its potential complications. The patient had an inadequate tooth display upon smiling and a deep lower curve of Spee. Treatment consisted of a double jaw surgery with a maxillary three-piece LeFort to expand, downgraft, and advance the maxilla and a bilateral sagittal split osteotomy to advance the mandible. Treatment was staged so that the leveling of the mandibular arch was completed postsurgically by extrusion of the mandibular buccal segments. During surgery, the mandible was rotated clockwise at the osteotomy site to bring the chin down. This treatment approach resulted in a dramatic increase in the lower facial height, as well as an improvement in skeletal and occlusal relationships, with a much improved tooth display upon smiling, despite the few complications that occurred.
本文阐述了一种治疗成年患者骨骼Ⅱ类错牙合畸形合并深覆牙合和短面型的方法，并强调了该方法的局限性及其潜在并发症。患者微笑时牙齿暴露不足，Spee曲线过深。治疗包括双颌手术，采用上颌三件式LeFort截骨术来扩展、下移并前移上颌骨，以及双侧矢状劈开截骨术来前移下颌骨。治疗分阶段进行，以便术后通过下颌颊侧段的伸长来完成下颌牙弓的整平。手术过程中，在下颌截骨部位顺时针旋转下颌骨以使下巴下移。这种治疗方法使面下高度显著增加，骨骼和咬合关系得到改善，微笑时牙齿暴露情况也有很大改善，尽管出现了一些并发症。
