Department of Orthodontics, Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China; Department of Orthodontics, School and Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, People's Republic of China.
Department of Orthodontics, Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.
Am J Orthod Dentofacial Orthop. 2019 Jun;155(6):801-811. doi: 10.1016/j.ajodo.2018.06.020.
The purpose of this study was to evaluate the therapeutic effect of a hybrid treatment for hemifacial microsomia that combines distraction osteogenesis and a mandible-guided functional appliance to correct mandibular asymmetry.
This was a retrospective analysis of 10 patients with unilateral hemifacial microsomia who underwent mandibular ramus distraction osteogenesis in our hospital from February 2013 to July 2015. The cases were classified into 2 comparison groups: 5 patients were in the MG-DO group (distraction osteogenesis combined with an mandible-guided functional appliance) and 5 in the control group (distraction osteogenesis only). Anteroposterior cephalometric analyses were conducted before and after treatment. Soft tissue symmetry and the occlusal relationship were observed from facial and intraoral photographs. Statistical analyses were performed to determine changes between before and after treatment as well as intergroup differences.
The MG-DO group showed greater vertical elongation of the mandibular ramus and less overcorrection and mandibular deviation than the control group. Occlusal reconstruction was enabled by the mandible-guided functional appliance owing to a decrease in lateral shifting. The symmetry of both skeletal and soft tissues was significantly improved in the MG-DO group.
The hybrid technique combining distraction osteogenesis and the mandible-guided functional appliance proved to be effective in correcting canting and deviation during mandibular elongation, which improved facial symmetry and occlusal balance in patients with hemifacial microsomia.
本研究旨在评估一种联合应用牵引成骨术和下颌引导功能矫治器治疗单侧颜面短小畸形的混合治疗方法的疗效，以矫正下颌骨不对称。
本研究回顾性分析了 2013 年 2 月至 2015 年 7 月在我院接受下颌骨支抗牵引成骨术的 10 例单侧颜面短小畸形患者。将这些病例分为 2 个比较组：5 例为 MG-DO 组（牵引成骨术联合下颌引导功能矫治器），5 例为对照组（仅牵引成骨术）。治疗前后进行了头影测量分析。从面部和口腔内照片观察软组织对称性和咬合关系。进行统计学分析以确定治疗前后的变化以及组间差异。
MG-DO 组下颌支的垂直伸长量较大，过度矫正和下颌偏斜较少。由于侧向移位减少，下颌引导功能矫治器使咬合得以重建。MG-DO 组的骨骼和软组织对称性均显著改善。
联合应用牵引成骨术和下颌引导功能矫治器的混合技术在矫正下颌骨延长过程中的倾斜和偏斜方面是有效的，可改善单侧颜面短小畸形患者的面部对称性和咬合平衡。
