正颌外科手术的优先手术入路——考量因素与临床病例报告
Surgery First Approach in Orthognathic Surgery - Considerations and Clinical Case Report.
作者信息
Borges Thaynan Maximiano, Sol Izabella, de Castro Rodrigues Cristovão Marcondes, Peres Lima Felipe Gomes Gonçalves, Silva Claudia Jordão, Furtado Lair Mambrini
机构信息
Department of Oral and Maxillofacial Surgery, Traumatology and Implantology - Hospital de Clínicas, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil.
出版信息
Ann Maxillofac Surg. 2021 Jul-Dec;11(2):349-351. doi: 10.4103/ams.ams_8_21. Epub 2022 Feb 1.
THE RATIONALE
The surgery first approach is a safe and stable procedure for the correction of dentofacial deformities that requires little orthodontic correction, leading to a faster return of functions.
PATIENT CONCERNS
Patient with facial discrepancies seeks treatment that returns function and aesthetics, requiring a less prolonged treatment with adequate results.
DIAGNOSIS
Clinical, facial, and radiological image analysis was used for diagnosis and treatment plan.
TREATMENT
Surgery first approach was performed in a patient with facial pattern II dolichocephalic, vertical maxillary excess, mandibular growth deficiency, aesthetic, and functional complaints, with the completion of the orthodontic treatment in 15 months.
OUTCOMES
Follow-up of 36 months showed no evidence of recurrence of the initial condition and occlusal stability was maintained. The patient had no more functional and aesthetic complaints.
TAKE-AWAY LESSONS: Aesthetic and functional improvements were observed more rapidly due to the correction of the skeletal deformity, with improvement in behavior and self-esteem.
理论依据
手术优先方法是一种安全稳定的治疗牙颌面畸形的方法，几乎无需正畸矫治，能更快恢复功能。
患者诉求
面部存在差异的患者寻求能恢复功能和美观的治疗方法，希望治疗时间较短且效果良好。
诊断
采用临床、面部及影像学分析进行诊断并制定治疗方案。
治疗
对一名面部呈Ⅱ型长头型、上颌垂直过度、下颌生长不足且有美观及功能问题的患者实施了手术优先方法，正畸治疗在15个月内完成。
结果
36个月的随访显示，初始病情无复发迹象，咬合稳定性得以维持。患者不再有功能和美观方面的问题。
经验教训
由于骨骼畸形得到矫正，美观和功能改善出现得更快，患者的行为和自尊也有所改善。
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