18例颏部取骨骨移植术供区软组织切口效果的临床观察.docVIP

18例颏部取骨骨移植术供区软组织切口效果的临床观察 周磊，徐淑兰，黄建生，徐世同，宋光保，张雪洋 An observation on the result of the incision healing of the donor sites in 18 cases undergoing the chin bone grafting procedure ZHOU Lei, XU Shu-lan, HUANG Jian-sheng, XU Shi-tong, SHONG Guang-bao, ZHANG Xue-yang.（Southern Medical University , Guangdong Provincial Stomatological Hospital, Guangzhou, 510280, Guangdong province , China） 【Abstract】Objective: summarize the results of wounds healing process in two incision design at donor sites in the chin bone grafting procedure ;Introduce the better surgical procedure for the donor sites. Methods: 18 consecutive patients underwent onlay bone grafting from the mandibular symphysis for harvesting intraoral autografts. 8 cases via incision at the mandibular vestibular groove and 10 cases via incision at the attached gingiva. The wound healing after the operation was observed . Results: In the vestibular groove incision group , the wound healed uneventfully in 6 of 8 cases, there were dehiscence in 2 cases ,the scars were obvious in all the case of this group . In the attached gingival incision group, all the wound of 10 cases healed uneventfully with very unconspicuous scars . Conclusion: The attached gingival incision design is profitably for adequate access to the donor sites and easier adaptation of the flap for tension-free closure. Keywords:　bone graft ; Onlay bone graft; Incision design [摘要] 目的 总结18例颏部供骨骨移植术中两种软组织切口设计的伤口愈合情况。对其中较理想的供区手术方式进行了介绍。方法 18例下颌骨颏部供骨Onlay 植骨的患者，随机选择了8例采用前庭沟切口设计；10例患者采用附着龈切口设计。结果 8例前庭沟切口设计者当中，6例一期愈合，2例出现伤口裂开；所有8例患者术后皆形成较为明显的瘢痕。10例附着龈切口设计患者术后伤口皆一期愈合，且愈合后无明显的瘢痕形成。结论　附着龈切口设计能提供较理想的手术入路并能较好地达到无张力复位组织瓣。 [关键词] 骨移植；Onlay骨移植；切口设计 下颌骨颏部可提供相对丰富的松质骨及皮质骨来源，在牙槽嵴骨增量技术中是常用的块状骨供骨区。目前有关颏部取骨的手术操作中，对取骨的技术本身有较多的关注，但对于颏部取骨时软组织切口的研究，则较少有报道，但软组织切口的选择，对于减少术后并发症，术后的正常愈合进程有很大关系。本文对颏部取骨的两种软组织切口进行比较研究并重点介绍了根据我们的临床实践认为较好的附着龈切口手术方式，希望对此类手术的开展有所借鉴。 ＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿ [基金项目] 广东省科技三项经费计划项目　2006国家十一五科技支撑计划2007BAI18BO6 [作者单位]南方医科大学