摘要目的 探讨应用正颌联合术后正畸矫治骨性Ⅲ类错牙合畸形的临床效果.方法2012年1月至2014年8月,采用无术前正畸的"手术优先法"矫治9例骨性Ⅲ类错牙合畸形患者;其中,男2例,女7例,年龄15~28岁,平均19.7岁;9例患者均有明显的下颌前突畸形.术后2~3 d行颌间牵引,固定上下颌于牙合板 ,2~3 d更换一次橡皮圈,持续 4周左右.待患者面部肿胀基本消退,上下颌位置关系趋于稳定,拆除牙合板,进入常规正畸治疗阶段.结果 9例患者术后经过6.5~19.5个月的正畸治疗,面型均得到了极大的改善,患者本人及家属感到满意,咬合功能恢复正常.随访3~32个月,术后外貌及咬合关系良好,无明显复发现象. 结论 采用"手术优先方法"能够有效矫治骨性Ⅲ类错牙合畸形导致的牙颌面畸形.

abstractsObjective To investigate the the treatment of class Ⅲ malocclusion by orthognathic surgery combined with postoperative orthodontics.Methods Nine patients with skeletal class Ⅲ malocclusion were treated by "surgery-first approach" without pre-surgical orthodontic from January 2012 to August 2014.The studied sample consisted of 7 women and 2 men (aged 15-28 years old, mean age 19.7 years), who had obvious mandibular protrusion.2 to 3 days after surgery, intermaxillary traction was used to made the maxilla and mandible together by board;we replaced a rubber band every 2 to 3 days and lasted for four weeks.We would dismantle board and performed conventional orthodontic treatment after patient's facial swelling subsided, and the positional relationship between the jaw stabilized.Results The face type of 9 patients were greatly improved after orthodontic treatment for 6.5 to 19.5 months.Patients and their family members felt satisfied, and their occlusal function returned to normal.At 3 to 32 months follow-up, the postoperative appearance and occlusion were becoming good without obvious signs of recurrence.Conclusions The "surgery-first approach" is an effective method to treat skeletal class Ⅲ malocclusion.