Wolford L M, Chemello P D, Hilliard F
Baylor College of Dentistry, Dallas, Texas.
Am J Orthod Dentofacial Orthop. 1994 Sep;106(3):304-16. doi: 10.1016/S0889-5406(94)70051-6.
The angular relationship of the occlusal plane and Frankfort horizontal (occlusal plane angle, normal value 8 degrees +/- 4 degrees) is very important, in both diagnosis and treatment planning, but is usually ignored. Surgical alteration of the occlusal plane may influence presurgical orthodontic mechanics and surgical technique and design, but may offer significant benefits relative to the patient's functional and esthetic results. Candidates for surgical alteration of the occlusal plane angulation include the low occlusal plane (LOP) facial type and the high occlusal plane (HOP) facial type. Correction of the LOP facial type by downward and backward (clockwise) rotation of the maxillomandibular complex has been a well accepted technique. Upward and forward (counter-clockwise) rotations of the maxillomandibular complex for correction of the HOP facial type has not been supported as an acceptable treatment modality. However, we have demonstrated that upward and forward rotations are stable with proper treatment planning, appropriate presurgical orthodontics, proper execution of the surgery, and in the presence of healthy and stable temporomandibular joints. This article will discuss the clinical characteristics of the LOP and HOP facial types, the specific anatomic changes with alteration of the occlusal plane, the presurgical orthodontic goals, and the surgical techniques for downward and backward and upward and forward repositioning of the maxillomandibular complex. Cases are presented to demonstrate the application of this treatment approach.
咬合平面与法兰克福平面的角度关系（咬合平面角，正常值为8度±4度）在诊断和治疗计划中都非常重要，但通常被忽视。咬合平面的手术改变可能会影响术前正畸力学以及手术技术和设计，但相对于患者的功能和美学效果可能会带来显著益处。咬合平面角度手术改变的候选对象包括低咬合平面（LOP）面型和高咬合平面（HOP）面型。通过上颌下颌复合体向下和向后（顺时针）旋转来矫正LOP面型一直是一种广为接受的技术。通过上颌下颌复合体向上和向前（逆时针）旋转来矫正HOP面型尚未被支持作为一种可接受的治疗方式。然而，我们已经证明，通过适当的治疗计划、合适的术前正畸、手术的正确实施以及在健康稳定的颞下颌关节存在的情况下，向上和向前旋转是稳定的。本文将讨论LOP和HOP面型的临床特征、咬合平面改变时的具体解剖学变化、术前正畸目标以及上颌下颌复合体向下和向后以及向上和向前重新定位的手术技术。通过病例展示这种治疗方法的应用。
