兩顎 齒槽前突의 矯正-外科的 複合顎矯正 2例

COMBINED SURGICAL AND ORTHODONTIC TREATMENT OF BIMAXILLARY DENTO-ALVEOLAR PROTRUSION : Report of 2 Cases

This is to report 2 cases of bimaxillary dentoalveolar protrusion corrected by anterior segmental osteotomies and following orthodontic treatment. The summary and results are as follows; 1. The protruded anterior alveolar segments of both arch were retruded by anterior subapical ostectomies after extraction of first premolar: Wunderer s labio-palatal approach on the maxilla and Köle s labial approach on the mandible. 2. The surgery was preceded by preoperative control of anterior spacing, cephalometric prediction studies, model surgery and fabrication of intra-arch acrylic resin splints. 3. Repositioned anterior segments were immobilized by prefabricated palatal or lingual resin splints for 6 weeks without intermaxillary fixation, and prolonged stabilization was gained by removable retention plate or orthodontic arch wires. 4. Crowding of anterior teeth and the step defect in the interface between the proximal and distal segments were controlled by postsurgical orthodontic treatment for 3 months. 5. Common sequelae of ecchymosis and swelling disappeared in 5-10 days after surgery, and vital response of anterior teeth could be checked as positive in postoperative 3 months. 6. 1 year follow-up evaluation revealed satisfactory result in view of correction of lip incompetence, facial change and uneventfual bony union.