下颌骨种植修复前改良神经旁移术

The monoblock cortical osteotomy to laterialize IAN before implant rehabilitation

目的 采用整块骨皮质切骨开窗神经旁移术创建下颌骨严重吸收的种植牙修复前条件。方法 为12例患者施行整块骨皮质切骨开窗神经旁移术,移位18条神经血管束,所有的神经血管束保持完整,随访术后7d^60个月。进行了客观检测和主观问卷调查。结果 38.9%(7/18)术后有神经感觉功能紊乱表现;100%(12/12)的病人均经历过主观感觉异常,但不影响正常生活,2~7个月有不同程度的恢复。结论 整块骨皮质切骨开窗神经旁移术是一种既安全又简便的方法,适于牙槽骨严重萎缩但神经管上到牙槽嵴顶的距离至少需3mm的病例。

Objective Adapting monoblock cortical osteotomy to laterize inferior alveolar nerve(IAN) as implant preprosthetic operation for severe mandible atrophy.Methods Eighteen IAN bundles were transposed in 12 patients before implant insertion. All IAN remained intact during the surgical procedures. The following-period was from 7 days to 60 months.Objective tests and subjective investigations were performed. Results The rate of neurosensory disturbances was 38.9%(7/18) with the objective test. Abnormal neurosensations were found to be 100%(12/12) for the subjective investigations. The complete recovery time varied greatly from 2 days to 7 months.Conclusion Monoblock cortical osteotomy is a reliable and simple technique to be performed, suitable for those cases which have at least a 3mm distance between the upper border of the IAN and the top of the alveolus.