文档介绍：手术优先正颌模式治疗牙颌面畸形的研究进展
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[摘要]牙颌面畸形传统的正颌正畸联合治疗流程是正畸优先，即术前正畸去代偿，正颌手术截骨，术后正畸精细调整。这种传统治疗模式的疗程较长，同时术前正畸去代偿会使患者在短期内的面部畸形加重。近年来，手术优先方案（Surgery-first approach，SFA）被越来越多地应用于牙颌面畸形的治疗。与传统的正畸优先方案相比，SFA没有进行以牙齿去代偿为目的的术前正畸治疗，从而缩短了治疗周期，并避免了因术前正畸去代偿所导致的短期面型恶化问题。本文对手术优先正颌模式在牙颌面畸形治疗中的有关热点问题进行综述，以期为临床医生在选择该模式治疗患者时提供一定的参考价值。
[关键词]手术优先;正颌外科;牙颌面畸形;正畸治疗;适应证;稳定性
[中图分类号] [文献标志码]A [文章编号]1008-6455（2020）07-0172-04
Abstract：In surgical-orthodontic correction of dentofacial deformities， the conventional three-stage treatment protocol includes presurgical orthodontics for dental decompensations，orthognathic procedure and postsurgical orthodontic conventional orthodontics-first approach has an unfavorable long treatment period for preoperative orthodontic at the same time， the patient's facial deformity will become more evident during the decompensation period. In recent years， a surgery-first approach （SFA） has been increasingly used in the treatment of dentomaxillofacial contrast to the conventional orthodontics-first approach，the SFA without presurgical orthodontics for dental decompensations potentially shortens the total treatment time and avoids short-term facial deterioration caused by dental decompensations because skeletal problems are corrected from the this article，some related hot issues of SFA in the treatment of dentomaxillofacial deformities were reviewed， aimed to provide clinicians with a certain reference value when choosing the SFA to treat patients.
Key words：surgery-first approach;orthognathic surgery; dentomaxillofacial deformities; orthodontics; indications; stability
牙頜面畸形，传统的正颌正畸联合治疗采用的是正畸优先方案，需要先行术前正畸去代偿治疗，排齐牙列，协调上下牙弓宽度，然后再进行正颌手术截骨。这种传统方案旨在通过术前正畸去代偿，在手术前明确所有骨性问题的严重程度，从而为骨骼畸形提供最佳的手术纠正。然而，在采用正畸优先方案时，患者在术前正畸阶段的骨骼畸形会变得更加明显甚至严重恶化，这是患者最主要