【简答题】
试述现代正颌外科的概念和主要步骤。
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答案
牙颌面畸形，主要系指因颌骨生长发育异常所引起的颌骨体积、形态，以及上下颌骨之间及其与颅面其他骨骼之间的关系异常和随之伴发的关系及口颌颌系统功能异常，外观则表现为颌面形态异常。以研究和诊治牙颌面畸形为主要内容的学科称正颌外科学。集口外、正畸、美学、心理、解剖、生理等相关学科的新理论、新进展和新技术为一体，特别是采用现代外科手术和正畸治疗相结合的方式，并应用新型专用手术器械，矫治通常由单独正畸治疗或手术治疗均难以达到满意效果的骨性牙颌面畸形。常规治疗步骤：
（1）术前正畸治-在调整不协调的牙弓与牙颌关系，排齐牙列，消除牙代偿性倾斜
（2）确认已定手术计划--前正畸结束后，应对原定手术计划进行一次最后评估和预测，必要时可对原方案进行适当调整和补充。
（3）完成术前准备--常规的全麻术前准备外，应按设计的术式，制备好引导板及骨段移动至矫正位后的固定装置。并根据手术计划，预测效果以及可能出现的问题和对策，向病人做充分的说明并取得其理解与配合。
（4）正颌手术--必须依照经预测确认的手术设计按步施术，不得在术中随意改动，但根据术中实际情况进行必要的适当调整是允许和应当注意的。
（5）术后正畸治疗----在从功能及形态效果出发，完善牙列及咬合关系，巩固治疗效果。
（6）随访观察--了解术后颌、合关系可能出现的变化，进行必要的处理，并行最后的效果评价。矫正后的骨段，在愈合过程中，往往会出现轻微的移位，只要不影响预测效果，一般不作特殊处理。如出现明显移位时，即应查明原因进行相应处理。术后严密随访观察至少6个月，其后可每半年复查一次。
解析
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