Abstract:
In this study, the authors aimed to describe orocraniofacial features and to suggest orthodontic-surgical managements in achondroplasia, based on a literature review. The authors focused on skeletal and dentoalveolar malocclusion in order to highlight the place of orthognathic surgery, based on our experience of 3 patients. Maxillary hypoplasia in achondroplasia typically results in an Angle class III malocclusion with an anterior open bite. The other orocraniofacial features include enlarged calvarium, prominent forehead and frontal bossing, midface hypoplasia, elongated lower face and saddle-shaped nose due to lack of development of the nasomaxillary complex.All our patients had a typical facial appearance but each of them had their own particularities regarding medical history and severity of the dentoskeletal dysmorphosis. Two of them were successfully treated by orthognathic surgery; the other declined surgical treatment and underwent orthopedic treatment only (anchorage plates). The treatment failure of this 3rd patient raises the question of the efficiency of anchorage plates in achondroplasia. In the light of the literature and our results, the authors conclude the need for personalized management based on age, medical history, severity of the dentoskeletal dysmorphosis, functional and/or esthetic disorders, and the patient\'s needs and requests. In any patient, orthodontic management should be initiated at an early age, and orthognathic surgery modalities should be personalized and adapted to each situation.
摘要:
在这项研究中,作者旨在描述口面部特征,并建议软骨发育不全的正畸手术治疗,基于文献综述。作者专注于骨骼和牙槽牙合畸形,以突出正颌手术的位置,根据我们对3名患者的经验。软骨发育不全的上颌骨发育不全通常会导致AngleIII类错牙合,并伴有前部开放咬合。其他口面特征包括颅骨扩大,突出的额头和额头,脸中部发育不全,由于缺乏鼻腋窝复合体的发育,拉长的下脸和鞍形的鼻子。我们所有的患者都有典型的面部外观,但每个患者在病史和骨骼畸形的严重程度方面都有自己的特殊性。其中两个通过正颌手术成功治疗;另一个拒绝手术治疗,仅接受骨科治疗(锚固板)。第三例患者的治疗失败引发了软骨发育不全中锚固板的效率问题。根据文献和我们的结果,作者总结了基于年龄的个性化管理的需求,病史,牙齿骨骼畸形的严重程度,功能和/或美学障碍,以及病人的需要和要求。在任何患者中,正畸治疗应该在早期开始,和正颌手术的方式应该是个性化的,并适应每一种情况。