Abstract:

Abstract：In orthodontic treatment，we may often deal with borderline cases，in which both extraction and non-extraction treatment may be suitable，or both surgery and non-surgery treatment may be reasonable. Thus，the treatment plan for borderline cases troubles orthodontists. Based on principles and essence，this article discussed the factors influencing extraction decision-making and the qualitative and quantitative indications of orthognathic surgery，and analyzed the challenges and traps in dilemmas.

Key words: orthodontics, extraction, treatment, orthognathic surgery

摘要：

在正畸治疗中，我们常遇到一些在选择拔牙不拔牙或手术不手术治疗方案时模棱两可的病例，称为临界病例。临界病例矫治方案的制定困扰着很多正畸医生。本文从原则、实质出发，探讨影响拔牙决策的诸多因素以及正畸正颌联合治疗的定性、定量指征，并对一些两难病例及其治疗中的挑战、陷阱等进行了分析，以期为正畸临床治疗方案的制定提供参考。

关键词: 口腔正畸, 拔牙, 矫治, 正颌外科