颌间结扎钉和牙弓夹板行颌间牵引固定的比较

A comparison between IMF screws and arch bars for the intermaxillary fixation of mandibular fractures HU

目的:比较2种不同的颌间牵引固定方法在颌骨骨折治疗中的价值。方法:对93例颌骨骨折患者实行颌间牵引固定,分别使用植入式钛钉(QUICK-FIXTM,OsteoMed公司,美国)和牙弓夹板,检测2组患者咬合关系恢复情况和2种操作所需的时间,并在5个不同的时间点测定DI、GI、CPITN指数,从咬合关系恢复、操作简易性和对口腔卫生的影响3个方面对2种方式进行比较;采用组间均数t检验进行统计学处理。结果:2种方法均能成功恢复咬合关系,但植入式钛钉使用更快捷,2组的DI、GI指数在进行颌间牵引固定后均有上升,但使用牙弓夹板患者的上升幅度显著高于使用QUICK-FIXTM颌间固定系统的患者(P<0.001),QUICK-FIXTM颌间固定系统组CPITN指数无明显变化,但牙弓夹板组出现上升,尤其是在拆除牙弓夹板后升高显著(P<0.01)。结论:植入式钛钉是一种更快捷、安全、卫生且效果良好的颌间牵引固定方法,为颌骨骨折治疗提供了新的途径和方法,值得临床推广。

PURPOSE: This study was designed to compare and evaluate two types of IMF techniques used in the therapy of maxillofacial fracture. METHODS: In this study, 93 cases underwent intermaxillary traction and fixation with self-tapping titanium screws (QUICK-FIXTM, OsteoMed Corp, America) or arch bars, the evaluation was focused on three aspects: the ability to restore the correct occlusion, the convenience to use and the influence on oral hygiene. The occlusion relationship, the time for operation and the DI, GI, CPITN indexes were tested. Two-sample/group t-test for independent samples was used in the statistical analysis. RESULTS: The correct occlusion could be achieved by both techniques, but the titanium screw was quicker to apply. The indexes of DI, GI rose in each group, but in the arch bar group they were significantly greater (P<0.001). There was no change of CPITN indexes in QUICK-FIXTM group, but increase was observed in the arch bar group, especially after the removal of the arch bar (P<0.01). CONCLUSION: It was concluded that titanium screw was a time-saving, safe, hygienical and reliable IMF technique, and it was a new method for the therapy of maxillofacial fracture and deserved to be recommended.