坚强内固定技术在牙颌面畸形外科矫治中临床应用探究.docVIP

坚强内固定技术在牙颌面畸形外科矫治中临床应用探究 　 作者：林润台　宿玉成 徐刚 杜鹃 【关键词】 坚强内固定 　　［摘要］ 目的：探讨坚强内固定技术在牙颌面畸形外科矫治中应用的先进性、可行性及实用性。方法：本组颌骨畸形病例68例，男性26例，女性42例。除单纯颏成形术外，其他所有病例术前均行正畸治疗。根据临床设计，全麻下分别采用下颌升支矢状劈开截骨术、上颌骨Lefort Ⅰ型截骨术、颏成形术、上下颌骨根尖下截骨术等不同术式，劈开截骨，按设计要求移动骨块，预制钛板进行坚强内固定。术后均行简单的颌间弹性牵引固定1~2周。结果：1例单侧创口感染延期愈合，1例术后1年钛板露出，二次手术取出钛板。其他病例创口一期愈合，术后经正畸治疗，牙合关系恢复正常，术后随访5个月至6年无复发，临床效果满意。结论：坚强内固定技术在牙颌面畸形外科矫治中的应用具有明显的优点：术后效果稳定，无复发，并发症少，不影响饮食、语言，患者恢复快。 　　［关键词］ 坚强内固定 牙颌面畸形 　　The Clinical Study of Rigid Internal Fixation Technique in Surgical Correction of Dento-maxillofacial Deformities. 　　　［Abstract］Objective: To study the feasibility and advantage of rigid internal fixation( RIF) in surgical correction of dento-maxillofacial deformities. Methods: 68 dento-maxillofacial deformity cases were included, of which there were 26 males and 42 females. Othordontics treatments were necessary for all cases except genioplasty before operation. Under general anesthesia,we cut the bone by sagittal split ramus osteotomy, Lefort-Ⅰ osteotomy, genioplasty, maxillo-mandibule subapical osteotomy, then moved the bone segements to the predictive place in according to the plaster models. The bone segements were fixed with the two RIF systems. One week after operation the rubber rings were used to draw mandibule and maxilla closely to keep good occlusion. Results: One case was infected with one side wound and delayed healing. The titanium plate was exposed in a case one year after operation and then taken off. In other cases the wound healed uneventfully. Orthodontic treatments were necessary to keep occlusion balance. There were no relapses from 5 months to 6 years follow-up. Clinical results were satisfactory. Conclusion: In surgical correction of dento-maxillofacial deformities, RIF provided many advantages: good stability, no relapse and less complication, rapid recovery, less inconvenience in speech and eating. 　　［Key words］ Rigia internal fixation Dento-maxillofacial deformities 坚强内固定技术是当代正颌外科学中一个必不可少的重要组成部分，正颌外科的坚强内固定技术是在借用