手术优先模式矫治成人严重骨性Ⅲ类错n 畸形n

• 作 者: 吕航苗 李小彤
• 机 构: 北京大学口腔医学院·口腔医院正畸科，口腔数字化医疗技术和材料国家工程实验室，口腔数字医学北京市重点实验室 100081
• 出 处: 中华口腔正畸学杂志
• 发表日期: 2020年2期
• 关键词: 重度骨性Ⅲ类 手术优先模式 术后稳定性 最小术前正畸准备

手术优先模式(surgery-first，SF)是指正颌手术之前不接受任何使牙齿移动的正畸治疗，或只接受不超过6个月的最小术前正畸准备(minimal orthodontic preparation，MOP)的治疗模式。在传统的术前正畸－正颌手术－术后正畸模式(conventional surgery，CS)中，术前正畸去代偿疗程较长，且常给骨性Ⅲ类患者的面型及咀嚼功能方面带来负面影响，因此，手术优先模式应运而生。然而手术优先模式患者术后咬合状况多不稳定，增加了术后复发的风险。本文旨在对骨性Ⅲ类手术优先模式的发展、优势与局限、适应证、术后稳定性等方面做一简要综述。“,”The surgery-first(SF) approach is a clinical treatment that proceeds with the orthognathic surgery in the beginning without presurgical orthodontic preparation or with minimal orthodontic preparation(MOP)for less than 6 months. Preoperative orthodontic procedures of conventional orthodontic-orthognathic treatment requires longer pre-surgery time, and patients with skeletal Angle Class Ⅲ malocclusion suffer from negative esthetic and functional effects. SF has been proposed to resolve thes erelevant inconveniences. However, compared to conventional treatment, SF approach has a relatively unstable postoperative occlusion which increases the risk of relapse. This article summarizes the history, advantages and disadvantages, indications, and post-operative stability of SF in skeletal Class Ⅲ malocclusion.