坚固内固定钛板系列在矫治牙颌面畸形中的应用

目的探讨钛板系列支持的坚固内固定技术在矫治牙颌面畸形的临床应用价值。方法本组颌骨畸形病例24例,男性8例,女性16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LefortⅠ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,预制钛板进行坚固内固定。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Ⅰ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。结论坚固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。

Objective To study the clinical value of titanium series on the support of rigid internal fixation technology in the treatment of dental and maxillofacial deformities. Methods 24 dento maxillofacial deformity cases were included, of which there were 8 males and 16 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 3 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.