Park Kitae E, Maniskas Seija, Allam Omar, Pourtaheri Navid, Steinbacher Derek M
Section of Plastic and Reconstructive Surgery, Department of Surgery, Yale School of Medicine, New Haven, CT, USA.
Yale Division of Plastic and Reconstructive Surgery, New Haven, CT, USA.
Aesthet Surg J Open Forum. 2020 Nov 19;3(1):ojaa051. doi: 10.1093/asjof/ojaa051. eCollection 2021 Jan.
A concave profile with class III malocclusion is most often due to a combination of maxillary hypoplasia and mandibular hyperplasia. Surgical correction entails normalization of jaw positions and is more challenging in the setting of concurrent asymmetry and open bite. Treatment should optimize both facial harmony and occlusion. Orthognathic surgery for class III deformities occurs at skeletal maturity and should address all aspects of the condition while preventing unnecessary emotional stress from delayed treatment. In this article, the authors describe the 3-jaw orthognathic surgery technique to address maxillary hypoplasia, mandibular prognathism, open bite, and mandibular asymmetry in a single procedure. The process of preoperative 3-dimensional (3D) virtual surgical planning, detailed surgical technique, fat grafting, and a comparison of preoperative and postoperative 3D aesthetic outcomes is presented. Additionally, a retrospective review of postoperative outcomes of 54 patients who received 3-jaw orthognathic surgery is presented as well.
III类错牙合的凹面型通常是由上颌发育不全和下颌增生共同导致的。手术矫正需要使颌骨位置正常化，在同时存在不对称和开牙合的情况下更具挑战性。治疗应优化面部协调性和咬合关系。III类畸形的正颌手术在骨骼成熟时进行，应解决病情的所有方面，同时避免因延迟治疗而产生不必要的情绪压力。在本文中，作者描述了一种三颌正颌手术技术，可在单一手术中解决上颌发育不全、下颌前突、开牙合和下颌不对称问题。文中介绍了术前三维（3D）虚拟手术规划过程、详细的手术技术、脂肪移植以及术前和术后3D美学效果的比较。此外，还对54例接受三颌正颌手术患者的术后结果进行了回顾性分析。
