上海口腔医学 ›› 2019, Vol. 28 ›› Issue (5): 449-454.doi: 10.19439/j.sjos.2019.05.001

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凹面畸形诊断、分类与生长趋势预判

沈刚   

  1. 上海泰康拜博口腔医院,上海 200001
  • 收稿日期:2019-07-05 出版日期:2019-10-25 发布日期:2019-12-11
  • 通讯作者: 沈刚,E-mail:gangshen@orthosh.com
  • 作者简介:沈刚(1964-),男,博士,教授,博士研究生导师

Classification for retrognathism malocclusions and its predictive assessment of progressive growth patterns

SHEN Gang   

  1. Shanghai Tai Kang ByBo Dental Hospital.Shanghai 200001, China
  • Received:2019-07-05 Online:2019-10-25 Published:2019-12-11

摘要: 根据面部特征、牙槽相对基骨代偿程度、咬合关系及颌骨形态等要素,凹面畸形可分为牙槽性、颌位性、骨源性(包括上颌源型、下颌源型及上、下源型)3大类。在头颅侧位片,牙槽性、颌位性及骨源性上颌源型,其下颌形态均呈扁长方形,而骨源性下颌源型及上、下源型均呈厚重三角形。从生长发育高峰初始期直至停止期,牙槽性、颌位性及骨源性上颌源型的生长型发展比较稳定,正畸矫形疗效较可靠;而骨源性下颌源型及上、下源型,其生长型严重程度呈增加趋势,而且下颌厚重三角形正中联合凹势越深,预后越差, 表明即使在早期经过正畸矫形治疗,将来畸形复发或仍需要手术干预的可能性较大。

关键词: 凹面畸形, 诊断, 分类, 下颌骨形态, 生长预判

Abstract: Classification for retrognathism malocclusions, assessed and determined by facial concavity, dento-basal compensation, skeletal discrepancy and mandibular morphology, includes dento-alveolar, mandibular positioning and skeletal categories. The skeletal category further consists of 3 subtypes, namely, maxillary originated, mandibular originated and maxillo-mandibular originated. The inspection of cephalometric images reveals that the mandibular contours in dento-alveolar, mandibular positioning and skeleto-maxillary originated categories present with flat and rectangular shapes; and in skeleto-mandibular originated and maxillo-mandibular originated subtypes, massive triangular shapes are distinctive. A longitudinal observation indicates that, spanning the course from the onset to the cessation of pubertal growth spurt, the prognosis of growth patterns remains stable and relatively favorable in dento-alveolar, mandibular positioning and skeleto-maxillary originated categories, but deteriorates and becomes unfavorable in skeleto-mandibular originated and maxillo-mandibular originated subtypes. The skeletal categories with triangle mandible coupled with deep curvature of symphysis hold high likelihood of relapse and are expected to achieve optimal correction by surgical interventions,although the orthopedic therapies are still advisable in the early stage.

Key words: Facial retrognathism, Diagnosis, Classification, Mandibular morphology, Growth pattern predictions

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