Turley P K
School of Dentistry, University of California, Los Angeles 90095-1668, USA.
Semin Orthod. 1996 Jun;2(2):138-53. doi: 10.1016/s1073-8746(96)80049-1.
A short lower face may accompany various types of malocclusions depending on the structural etiology. Because most cephalometric analyses focus on the anteroposterior plane of space, they are often insufficient in diagnosing a significant vertical dysplasia. This article describes a cephalometric analysis that examines not only the vertical proportions of the face, but the various anatomical features that contribute to the dysplasia. Diagnosis is further enhanced by evaluating the facial profile with the mandible postured at various amounts of opening, suggesting the degree of vertical discrepancy. Traditional orthodontic therapy corrects the associated malocclusion but is usually ineffective in changing inherent facial proportions. However, several orthopedic methods have shown the ability to increase lower facial height when used in combination with nonextraction orthodontic mechanotherapy. Adults with short faces require a combination of orthodontics and orthognathic surgery. The Class II malocclusion can usually be managed by surgically advancing the mandible with the curve of Spee maintained. In cases of vertical maxillary deficiency, the LeFort I osteotomy with inferior repositioning provides the spatial correction that is needed. Two cases are presented to illustrate the cephalometric and facial analyses used in diagnosis, as well as the common surgical procedures to manage the short face patient.
根据结构病因，短面型可能伴有各种类型的错牙合畸形。由于大多数头影测量分析集中在前后空间平面，它们在诊断明显的垂直发育异常方面往往不足。本文介绍了一种头影测量分析方法，该方法不仅检查面部的垂直比例，还检查导致发育异常的各种解剖特征。通过在下颌处于不同开口量时评估面部轮廓来进一步加强诊断，这表明了垂直差异的程度。传统的正畸治疗可纠正相关的错牙合畸形，但通常在改变固有的面部比例方面无效。然而，几种矫形方法已显示出与非拔牙正畸机械疗法联合使用时增加面下高度的能力。短面型成年人需要正畸和正颌手术相结合。II类错牙合畸形通常可通过手术推进下颌并保持Spee曲线来治疗。在上颌垂直发育不足的情况下，LeFort I截骨术并向下复位可提供所需的空间矫正。本文介绍了两个病例，以说明用于诊断的头影测量和面部分析，以及治疗短面型患者的常见外科手术。
