Malik Ovais H, Waring David T, Lloyd Richard, Misra Sangeeta, Paice Elizabeth
Dent Update. 2016 Jul-Aug;43(6):550-2, 555-8, 561-2. doi: 10.12968/denu.2016.43.6.550.
The correction of severe dentofacial discrepancies involving a combination of orthodontic and surgical therapies (termed ‘orthognathic treatment’) is commonplace. There is an abundance of evidence within this field but it is often inconsistent. This article is an evidence-based overview of such treatments and is aimed at the general dental practitioner. It will cover: the timing of treatment; the indications and risks associated with different surgical osteotomies; the magnitude of surgical movements that can be achieved with these procedures; and the importance of mandibular autorotation when planning treatment. Orthognathic treatment is considered to be the gold standard for comprehensive correction of severe dentofacial discrepancies. It is undertaken by a multidisciplinary team of clinicians involving, but not exclusive to, consultants in orthodontics and oral and maxillofacial surgery in secondary and tertiary medical centres throughout the United Kingdom. Clinical relevance: It is imperative that general dental practitioners have a good understanding of orthognathic treatment in order to recognize when such treatments are indicated, to inform the patient of possible treatment modalities and to be able to discuss associated risks in order to make appropriate referrals. Since treatment timing and magnitude of surgical movements have a profound effect on stability of the treatment result, these must be carefully considered by all clinicians involved in patient care to minimize relapse potential.
涉及正畸和外科治疗相结合（称为“正颌治疗”）的严重牙颌面畸形矫治很常见。该领域有大量证据，但往往不一致。本文是基于证据对这类治疗的概述，面向普通牙科医生。内容包括：治疗时机；不同外科截骨术的适应症和风险；这些手术所能实现的手术移动幅度；以及治疗计划中下颌自动旋转的重要性。正颌治疗被认为是严重牙颌面畸形综合矫治的金标准。它由多学科临床医生团队进行，包括但不限于英国各地二级和三级医疗中心的正畸和口腔颌面外科顾问。临床意义：普通牙科医生必须充分了解正颌治疗，以便识别何时需要此类治疗，告知患者可能的治疗方式，并能够讨论相关风险，从而进行适当的转诊。由于治疗时机和手术移动幅度对治疗结果的稳定性有深远影响，所有参与患者护理的临床医生都必须仔细考虑这些因素，以尽量减少复发的可能性。
