摘要：

唇腭裂是口腔颌面部最常见的先天性畸形，患者经历综合序列治疗后出现的不可避免的颌骨发育障碍仍是影响其咀嚼、面型及心理的重要问题。其常表现为面部三维方向的发育不足、上颌后缩及下颌真性前突、因上颌牙弓狭窄致牙列拥挤、咬合关系极度紊乱；与其他牙牙合面畸形相比，该病治疗难度大、术后复发率高，传统单纯牙列正畸矫治难以达到满意的效果。作者就收治的1例多次修复手术后伴发严重颌骨畸形的完全性唇腭裂患者，设计了个性化的治疗方案，应用计算机外科技术，采用了植骨-正畸-正颌-正畸的序列治疗计划，获得了良好的面型及咬合等效果，通过文献复习对该类复杂颌骨畸形的诊疗特点进行讨论。

关键词: 唇腭裂, 错牙合畸形, 正颌正畸

Abstract:

Cleft lip and palate is the most common congenital malformation in oral and maxillofacial region. The inevitable jaw dysplasia after comprehensive sequential therapy is still an important problem affecting mastication, facial morphology and psychology. It is often manifested as insufficient development in the three-dimensional direction of the face, retraction of the upper jaw and true protrusion of the lower jaw, due to maxillary arch stenosis, occlusal relationship is extremely disordered, which is difficult to treat compared with other maxillofacial deformities. The postoperative recurrence rate is high, and the traditional orthodontic treatment is difficult to achieve satisfactory results. In the present report, the author designed a personalized treatment plan for a patient with complete cleft lip and palate, who was accompanied by severe jaw malformation after multiple operations. Applied computer surgery technology, the sequential plan of bone graft - orthodontic - orthognathic - orthodontic was adopted. Functional and cosmetic outcomes were achieved. The diagnosis and treatment characteristics of the complex jaw deformity were discussed through literature review.

Key words: cleft lip and palate, occlusal surface deformity, orthodontic orthognathic surgery