口腔颌面外科学-牙颌畸形

1、牙颌畸形 Dentofacial Deformities病因学分类先天性畸形发育性畸形外伤后继发畸形感染后继发畸形营养因素发育性分类发育过度矢状向下颌骨上下颌骨发育不足横向垂直向上颌骨发育性分类发育过度矢状向下颌骨上下颌骨发育不足横向垂直向上颌骨发育性分类发育过度矢状向下颌骨上下颌骨发育不足横向垂直向上颌骨发育性分类双侧发病对称性畸形单侧发病不对称畸形诊断Diagnosis患者主诉Patient Concerns临床检查Clinical Exam.照相Photographs美学评价Aesthetical Eval.X线摄片Rx Images头影测量分析 Cephalometric Analys

2、is模型分析Model Analysis正畸正颌外科联合评价Joint Orthognathic-Orthodontic Assessment诊断Diagnosis患者主诉Patient Concerns临床检查Clinical Exam.照相Photographs美学评价Aesthetical Eval.X线摄片Rx Images头影测量分析 Cephalometric Analysis模型分析Model Analysis正畸正颌外科联合评价Joint Orthognathic-Orthodontic Assessment诊断diagnosis患者主诉Patient Concerns临床检查

3、Clinical Exam.照相Photographs美学评价Aesthetical Eval.X线摄片Rx Images头影测量分析 Cephalometric Analysis模型分析Model Analysis正畸正颌外科联合评价Joint Orthognathic-Orthodontic Assessment诊断diagnosis患者主诉patient concerns临床检查clinical exam.照相photographs美学评价aesthetical eval.X线摄片Rx Images头影测量分析 cephalometric analysis模型分析model analys

4、is正畸正颌外科联合评价Joint Orthognathic-Orthodontic Assessment侧貌轮廓面型facial profile直面型straight凸面型convex凹面型concave美学评价aesthetic evaluation协调的抽象感觉与比例的具体原则均衡的面高比例协调的鼻唇颏关系对称的重要性与相对性加滕非对称率Q=(G-K)/G*100%10%, 不对称诊断diagnosis患者主诉Patient Concerns临床检查Clinical Exam.照相Photographs美学评价Aesthetical Eval.X线摄片Rx Images头影测量分析 Ce

5、phalometric Analysis模型分析Model Analysis正畸正颌外科联合评价Joint Orthodontic & Surgical Evaluation诊断diagnosis患者主诉patient concerns临床检查clinical exam.照相photographs美学评价aesthetical eval.X线摄片Rx Images头影测量分析 cephalometric analysis模型分析model analysis正颌正畸外科联合评价Joint Orthognathic-Orthodontic Assessment头影测量标志点cephalometri

6、c landmarksABNS头影测量分析cephalometric analysis头影测量分析cephalometric analysis骨性III畸形头影测量骨性II畸形头影测量骨性I畸形头影测量模板外科 VTO电脑辅助头影测量分析面型预测诊断diagnosis患者主诉patient concerns临床检查clinical exam.照相photographs美学评价aesthetical eval.X线摄片Rx Images头影测量分析 cephalometric analysis模型分析Model Analysis正畸正颌外科联合评价Joint Orthognathic-Ortho

7、dontic Assessment牙颌模型分析dental cast analysis一般观察牙齿外形大小拥挤和错位中线位置前牙复合覆盖后牙合关系基骨发育情况牙颌模型分析dental cast analysis牙弓与基骨弓测量牙弓应有弧形长度牙弓现有弧形长度牙弓宽度测量牙弓长度测量牙弓对称度基骨弓测量宽度：左右第一前磨牙颊侧移行皱襞处牙槽骨最凹点之间的距离长度：左右中切牙唇侧黏膜移行处牙槽骨最凹点至左右第一恒磨牙远中触点连线之间的垂直距离牙颌模型分析dental cast analysis诊断diagnosis患者主诉Patient Concerns临床检查Clinical Exam.照相Ph

8、otographs美学评价Aesthetical Eval.X线摄片Rx Images头颅定位片 Cephalometric Eval.模型分析Model Eval.正畸正颌外科联合评价Joint Orthognathic-Orthodontic Assessment诊断diagnosis骨骼(含齿槽骨)skeletal (incl. dento-alveolar)牙列状况dentition颞下颌关节TMJ软组织soft tissues鼻唇组织nasolabial牙体组织endodontic牙周组织periosteal治疗计划的制定treatment planning术前、后正畸治疗计划Pre

9、 & Post-operative Orthodontics正颌外科手术方案Osteotomy Planning牙体、牙周病专科会诊Endodontic, Periodontological Consultation颞下颌关节病专科会诊TMD Consultation语言障碍CLP Center颌面软组织整复方案Soft tissue revisionor reconstruction牙颌面畸形患者的传统诊治流程Conventional Dx & Tx protocol for Dentomaxillofacial malformation改善面型Establish facial harmon

10、y & balance 治疗目的basic therapeutic goals重建口颌功能Rehabilitate normal mastication, speech, etc治疗目的basic therapeutic goals疗效稳定long-term stability治疗目的basic therapeutic goal疗程短Minimize treatment time治疗目的basic therapeutic goal正颌、正畸联合治疗Orthognathic & Orthodontic Treatment正颌、正畸联合治疗Orthognathic & Orthodontic Tr

11、eatment模型外科model surgery模型外科model surgery确定共同参考平面FH平面(frankfort plane)轴眶平面(axis-orbital plane, AOP)XXdental Impression取模face bow transfer 面弓转移dental cast mounting倒模、上合架（1+2付）reference marks确定面中线参考线及测量咬合关系的建立测量记录拼对合关系模型外科中的注意事项石膏模型的解剖形态清晰、牙齿无损坏或变形合架上做模型外科与头影测量、模板外科及面型预测相结合追求最佳的合关系术后稳定性的保证获得三维空间的立体概念指

12、导外科手术中的截骨部位、截骨量及牙骨段移动的方向和距离显示上、下牙弓的协调性及颌间关系的调整方法拼对出具有良好形态和功能的上、下牙咬合关系在完成模型外科后的牙合模型上制作合板和牙弓夹板 术中导板、术后固定模型外科的意义复习思考题牙颌面畸形的分类及诊断方法？正颌外科的治疗目的？头影测量方法在牙颌面畸形诊断中的价值？模型外科的意义？LJ Peterson, et al : Contemporary Oral and Maxillofacial Surgery. 4th ed. Mosby. Missorri. 2003W Booth, et al: Maxillofacial Surgery. Vol 1, 2. 1st ed. Churchill Livingstone. London. 1999Michael Miloro, et al: Petersons Principles of Oral and Maxillofacial Surgery, 2nd ed. Vol 1, 2. London. 2004邱蔚六主编.口腔颌面外科学. 第6版. 人民卫生出版社. 2008Fon