牵张成骨术治疗腭裂术后严重上颌骨后缩畸形.pdfVIP

维普资讯

实用El腔医学杂志(JPractStomato1)2007Nov，23(6)

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牵张成骨术治疗腭裂术后严重上颌骨后缩畸形

赵晋龙何黎升刘彦普商洪涛薄斌龚振宇

【摘要】目的：观察应用牵张成骨技术治疗腭裂术后继发的严重上颌骨后缩畸形的效果。方法：对l0例腭裂

术后继发严重上颌骨后缩畸形的患者，术前常规行头影测量和模型外科设计；手术采用上颌骨LeFortI型截

骨术，4例使用颅骨支抗外置式牵张器，其余患者采用内置式牵张器进行骨牵张术；术后延迟期为7d，牵张节

律为0．8—1mm／d，2—4次／d，牵张结束后固定8—12周。结果：术后伤I51一期愈合，牵张过程顺利，最大牵张

距离为22mm，最小距离为15mm；患者的面形得到明显改善，未出现畸形愈合或骨不连接等并发症。结论：牵

张成骨技术应用于腭裂术后继发的严重上颌骨后缩畸形，不需要植骨，可有效地达到上颌骨前徙、明显改善面

形的目的。

【关键词】牵张成骨；畸形；颌面部；腭裂；治疗

Distractionosteogenesisincorrectionofsevereretro--maxillarydeformityaftercleftpalatere--

pair

ZhaoJinlong，HeLisheng，LiuYanpu，eta1．DepartmentofOralandMaxillofacialSurgery，The

FourthMilitaryMedicalUniversity，Xifin710032，China

A【bstracts】Objective：Toinvestigatethedistractionosteogenesistechniqueincorrectionofsevereretro．maxillary

deformityfollowingtherepairofcleftpalate．Methods：10patientswereincludedinthestudy．Orthodontictreatment

wasusedasaregularprocedurebeforeoperation．Distractionosteogenesistechniquewasusedtocorrectthedefomrity

andmalocclusion．4ofpatientsappliedwiththeexternaldistractorandotherswithinternaldistractor．Latencyperiod

was7days．Distractionrhythmis0．8—1mm／d．2—4times／d．Consolidationperiodwas8—12weeks．Orthognathic

surgerywasdoneafterdistractionfinishedwhennecessary．Results：Thetreatmentprocesswassmoothandnosevere

complicationocCUlTed．Themxaimumofdistractiondistanceis22mm，andtheminimumofdistractiondistancewas

15mm．Nomalunionorununionoccurredinall10patients．Allthepatientsweresatisfiedwiththeresults．Conclu·

sion：Distractionosteogenesisismoresuitableforcorrectionofsevereretro—maxillarydefomrityfollowingtherepairof

cleftpalate．Bonetransplantationisunnecessaryduringtheoperationprocesswitheasierhandlingandlowerrisk．

【Keywords】Distractionosteogenesis；Maxillofacialarea；Deformity；czpalate；Treatment

中图分类号：R782．23文献标识码：A文章编号：1001—3733(2007)-06-0759-03

腭裂患者术后多伴有不同程度的上颌骨后缩畸