Li Yunfeng, Hu Zhiai, Ye Bin, Liu Yao, Ren Xiaochun, Zhu Songsong
Associate Professor, State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
Resident, State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
J Oral Maxillofac Surg. 2016 Dec;74(12):2505.e1-2505.e12. doi: 10.1016/j.joms.2016.08.032. Epub 2016 Aug 31.
Orthognathic surgery is an efficient procedure for cosmetic and functional aims. However, when functional improvement is achieved by mandibular or maxillary operations, additional esthetic corrections may be imperative for some patients. This study aims to introduce our primary practice of simultaneous facial bone contouring and orthognathic surgery for esthetic reasons.
Ten patients with dentofacial deformities as well as a prominent angle, asymmetric deformities, or a high zygoma and zygomatic arch were recruited from West China Hospital of Stomatology, Sichuan University (Chengdu, China), between January 1, 2014, and July 31, 2015. Traditional orthognathic surgical procedures such as bilateral sagittal split osteotomy and Le Fort I osteotomy combined with facial osteoplasty including mandibular angle ostectomy, outer cortex ostectomy of the mandibular angle, and zygoma and zygomatic arch reduction were performed. Radiographs and medical photographs were taken before and after surgery to compare the effectiveness of the combined use of facial osteoplasty and orthognathic surgery.
All patients had an uneventful postoperative recovery, with no signs of infection, jaw displacement, or osteonecrosis. Radiographs taken 1 week after surgery and pictures of the facial profile and occlusion taken 6 months after surgery showed satisfactory esthetic outcomes. All patients were satisfied with the functional and cosmetic results.
This study indicated the clinical feasibility of simultaneous facial bone contouring and orthognathic surgery for the treatment of dentofacial deformities. Simultaneous facial bone contouring seems to be an alternative procedure in addition to conventional orthognathic surgery for cosmetic aims in certain patients.
正颌外科手术是实现美容和功能目标的有效方法。然而,当通过下颌或上颌手术实现功能改善时,对一些患者而言,额外的美学矫正可能势在必行。本研究旨在介绍我们出于美学原因同时进行面部骨骼轮廓塑形和正颌外科手术的初步实践。
2014年1月1日至2015年7月31日期间,从四川大学华西口腔医院(中国成都)招募了10例牙颌面畸形患者,这些患者同时伴有下颌角突出、不对称畸形或高颧骨及颧弓。实施了传统的正颌外科手术,如双侧矢状劈开截骨术和Le Fort I截骨术,并结合面部骨整形术,包括下颌角截骨术、下颌角外板截骨术以及颧骨和颧弓缩小术。术前和术后拍摄X线片及医学照片,以比较面部骨整形术与正颌外科手术联合应用的效果。
所有患者术后恢复顺利,无感染、颌骨移位或骨坏死迹象。术后1周拍摄的X线片以及术后6个月拍摄的面部轮廓和咬合照片显示出令人满意的美学效果。所有患者对功能和美容效果均满意。
本研究表明,同时进行面部骨骼轮廓塑形和正颌外科手术治疗牙颌面畸形具有临床可行性。对于某些患者的美容目的而言,同时进行面部骨骼轮廓塑形似乎是传统正颌外科手术之外的一种替代方法。