国际口腔医学杂志 ›› 2026, Vol. 53 ›› Issue (6): 798-809.doi: 10.7518/gjkq.2026146
生长发育规律:科学性、创新性儿童早期矫治的再思考
摘要:
儿童错𬌗畸形早期矫治是在遵循颅面𬌗生长发育基本规律,深入认知遗传及环境因素在错𬌗畸形发生发展中的作用,科学选择最佳矫治时机、矫治适应证,及时预防及阻断错𬌗畸形的发生发展,以达到降低错𬌗畸形发生率、最大限度地维护颅面𬌗形态结构协调与美观,维护正常口腔功能及良好的口腔健康的临床治疗。笔者从颅面𬌗生长发育规律由上到下的遗传“层级”控制、颅面生长发育平衡与代偿特性等生长发育特性出发,深入思考颅面𬌗生长发育在错𬌗畸形早期矫治临床策略上的指导性意义,提出早期矫治的生物学观点,即颅及颅底的发育决定了面颌发育的遗传框架,良好的头颅形态是良好的面颌形态的基础,早期矫治不能纠正颅及颅底形态异常导致的骨性错𬌗畸形;但随颅面𬌗结构层级的下降,早期矫治的疗效越好。错𬌗畸形是颅面𬌗“平衡”与“代偿”的失败,早期矫治的策略就是要促进颅面𬌗的“代偿”效能,降低颅面𬌗生长的“不平衡”对面部形态及咬合关系的不良影响,降低错𬌗畸形的严重性及简化错𬌗畸形的复杂性。当代正畸学颅面𬌗生长发育控制理论的深化促进了错𬌗畸形早期矫治的发展,错𬌗畸形不再认为是受遗传因素单独控制的发育异常,环境因素的影响在错𬌗畸形发生发展中也起到相当重要的影响。上气道因素、口腔功能因素在面颌发育异常中的作用日益受到临床医生的高度重视,特别是针对气道阻塞导致的错𬌗畸形的早期矫治已成为早期矫治的重要内容,并得到口腔正畸医生、耳鼻喉医生的高度重视,其临床管理通常需要耳鼻喉科、睡眠医学、儿科等多学科协作。目前,错𬌗畸形早期矫治无疑是正畸学界的热点,开展错𬌗畸形早期矫治必须要遵循颅面𬌗生长发育规律,创新性的儿童早期矫治临床新技术必须以颅面𬌗生长发育规律为基础,这是促进儿童早期矫治健康发展的科学路径。
中图分类号:
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