Gaszyńska Ewelina
Department of Nutrition and Epidemiology, Medical University of Łódź, Poland.
Pol Merkur Lekarski. 2021 Feb 24;49(289):84-87.
Recently surgery first became more popular alternative for treatment of dentofacial deformities. In this approach treatment starts from orthognathic surgery. Immediately after othognathic surgery facial aesthetics and oral function are improved. Thus main complaints of the orthognathic patients are resolved early during treatment period. Indications for surgery first approach are wider than years ago and include: skeletal Class II and III malocclusion, skeletal open bite, bimaxillary protrusion, even cases with severe facial asymmetry are reported. The key point for gaining stable results and total treatment time shortening is an appropriate surgical occlusion. For higher precision of treatment 3D virtual planning is recommended. Total treatment time depends on: number of contact points in surgical occlusion, number of extracted teeth and postsurgical midline deviation. Surgery first is a good alternative approach in some patients treated for dentofacial deformities. Stability in this approach is similar to conventional method of treatment and both methods result in quality of life improvement. As there is lack of presurgical orthodontics in surgery first approach patients avoid transient deterioration in facial aesthetics and oral function that results in higher satisfaction and shorter total treatment time.
最近，手术优先成为治疗牙颌面畸形更受欢迎的一种选择。在这种治疗方法中，治疗从正颌手术开始。正颌手术后，面部美观和口腔功能立即得到改善。因此，正颌患者的主要诉求在治疗早期就得到了解决。手术优先方法的适应症比多年前更广泛，包括：骨性安氏II类和III类错牙合、骨性开牙合、双颌前突，甚至有报道称严重面部不对称的病例也适用。获得稳定效果和缩短总治疗时间的关键在于合适的手术咬合。为了提高治疗精度，建议采用三维虚拟规划。总治疗时间取决于：手术咬合中的接触点数量、拔牙数量和术后中线偏差。手术优先对于一些接受牙颌面畸形治疗的患者来说是一种很好的替代方法。这种方法的稳定性与传统治疗方法相似，两种方法都能改善生活质量。由于手术优先方法中没有术前正畸，患者避免了面部美观和口腔功能的暂时恶化，从而获得更高的满意度和更短的总治疗时间。
