Guyuron B
Division of Plastic Surgery, Mount Sinai Medical Center, Cleveland, Ohio.
Plast Reconstr Surg. 1988 Jun;81(6):948-51. doi: 10.1097/00006534-198806000-00021.
Arthritis of the temporomandibular joint and resulting deficient mandibular growth are seen in as many as 25 percent of patients with juvenile rheumatoid arthritis. The magnitude of joint involvement and resulting growth deficiency varies significantly. These patients typically develop a "birdface" deformity with retruding mandible, alteration of the cervicofacial angle, and class II occlusion with limitation of the bite opening. A multidisciplinary approach, including the surgeon, a dentist, an orthodontist, and a rheumatologist, is necessary to ensure a safe and successful surgical outcome. The side effects of pharmacologic agents used to control the disease on coagulation, healing, and bone density should be considered seriously.
颞下颌关节关节炎及由此导致的下颌骨生长不足在多达25%的青少年类风湿性关节炎患者中可见。关节受累程度及由此导致的生长不足差异显著。这些患者通常会出现“鸟脸”畸形，表现为下颌后缩、颈面角改变以及Ⅱ类错牙合伴开口受限。需要外科医生、牙医、正畸医生和风湿病学家等多学科协作，以确保手术安全且成功。应认真考虑用于控制疾病的药物对凝血、愈合和骨密度的副作用。
