不同颌间牵引结合可吸收内固定材料在下颌骨骨折的重建研究

目的:下颌骨骨折患者采用可吸收内固定材料进行固定,同时结合牙弓夹板或自攻钛钉进行术后颌间牵引固定,探讨两种牵引方式对患者口腔情况和术后咬合关系恢复的促进作用。方法:对65例下颌骨骨折病例在完成骨折坚固内固定的基础上分别应用牙弓夹板和自攻钛钉进行颌间牵引,14 d后拆除颌间牵引,术后3-6月进行复查,对患者术后及复查期间口腔情况和咬合关系进行评估,采用两组间t检验进行统计学分析。结果:所有35例患者伤口均一期愈合。两种技术相结合,即使全面部骨折和陈旧性骨折都获得了良好的疗效,不同颌间牵引结果显示采用自攻钛钉治疗更加简便,口腔卫生情况明显好于采用牙弓夹板的患者;复查显示两组患者咬合关系恢复理想,两者骨折愈合、张口度及咬合关系无明显差异。结论:采用可吸收材料进行颌骨固位是一种较先进的坚固内固定方法,颌间自攻钛钉是恢复及维持咬合关系较为理想的治疗方法,两者结合可以获得满意的效果,值得临床推广。

The Reconstruction Study on Treatment with Jaw Fracture using Different Intermaxil1ary Traction and Biodegradable Plates

Objective: To compare the rapeutical effect and oral hygiene after application of different intermaxillary traction through arch splint/ drill-free screw and biodegradable plates in the patients with jaw fracture.Methods: In 65 cases of jaw fractures,all patients were treated by rigid internalfixation combinanted with intermaxillary traction using dental arch splint or titanium screw.The evaluations including oral hygiene index and occlusion relationship were analyzed during hospitalization and 3-6 months after operation.Two-sample t-test for independent samples was used in the statistical analysis.Results: The comfortable outcome could be achieved through both techniques even if panfacial fracture and old fracture.The patients using titanium screw were easier to application and better oral health than those using dental arch splint.There was no significant difference upon fracture healing,mouth-opening degree and occluding relation under two methods.Conclusions: Using a biodegradable plate is a more advanced method of rigid internal fixation in the treatment with jaw fracture.Traction with screw is relatively ideal treatment method to restore and maintain the occlusion relationship compared with traditional intermaxillary traction.Combination with two methods can obtain satisfactory effect,worthy of clinical application.