Maxillary development revisited: Relevance to the orthopaedic treatment of Class III malocclusions
Maxillary development revisited: Relevance to the orthopaedic treatment of Class III malocclusions
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DOI：
10.1093/ejo/19.3.289
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发表时间：
1997-06-01
影响因子：
2.6
通讯作者：
Delaire, J
中科院分区：
文献类型：
--
作者：
Delaire, J
上颌骨的正常发育不仅与其组成骨骼单位的运动和表面的骨附着-吸收有关，而且与前外侧区的特殊发育有关。在III类病例中，骨骼畸形的矫正不仅需要上颌骨处于正确的位置（相对于下颌骨）并实现正确的咬合，而且需要外-前-前颌骨发育良好。这需要肌肉姿势（唇颏、舌、腭咽）和口面功能（鼻通气、吞咽、咀嚼）正常化。使用矫形面罩的后前牵引只能完成III类的部分治疗。该行动必须始终由旨在纠正前外侧区域发育不全的其他疗法来补充。面罩治疗不仅是简单的矢状面牵引，而且是一种真正的治疗III类的方法，它得到了很好的理解，并取得了很好的效果。考虑到安氏III类错牙合的解剖形式的巨大多样性，口外后前牵引产生广泛不同的结果并不奇怪。然而，质量主要取决于使用的方法。每次功能治疗不足时，正畸医生必须毫不犹豫地寻求外科医生的帮助，特别是在唇腭裂患者中，其结果更多地取决于外科手术，包括原发性和继发性手术，而不是牙面矫形术。
Normal development of the maxilla results not only from movements of its constituent skeletal units and bony apposition-resorption superficially, but also from the specific development of the antero-lateral regions. In Class III cases, correction of the skeletal dysmorphosis requires not only that the maxilla is in a correct position (in relation to the mandible) and that the correct occlusion is achieved, but also that there is good development of the exo-peri-premaxilla. This requires normalization of muscular posture (labio-mental, lingual, velo-pharyngeal) and of orofacial functions (nasal ventilation, swallowing, mastication). Postero-anterior traction using an orthopaedic mask can only accomplish part of the treatment of Class III. The action must always be complimented by other therapy aimed at correcting the underdevelopment of the antero-lateral regions. Facemask therapy is not only simple sagittal distraction, but is truly a method for treatment of Class III which is well understood and achieves excellent results. Taking into account the great diversity of anatomical forms of Class III malocclusion, it is not surprising that extra-oral postero-anterior traction gives widely varying results. The quality however, depends principally on the method used. Orthodontists must not hesitate to call for the assistance of a surgeon each time the functional treatment is insufficient, particularly in cleft patients where the results depend more on surgical procedures, both primary and secondary, than on dentofacial orthopaedics.