口内入路咬骨钳法矫正下颌角肥大畸形

Correction of prominent mandibular angle with a special bone rongeur through intraoral approach

目的介绍一种应用特制咬骨钳咬除肥大下颌角的矫治方颌畸形的新方法。方法采用口内入路，磨削下颌骨外板，标定需要咬除的下颌角范围，用特制的咬骨钳咬除下颌骨，再用骨锉将骨断面打磨光滑、平顺。自2006年8月至2009年10月，采用该方法矫治方颌畸形求美者128例。结果术后随访128例求美者1～36个月，其中125例下面部外形柔和、自然、流畅，效果满意。3例不满意，其中2例为左右不对称，1例为去骨量不足，均行Ⅱ期修复术得以矫正。咬骨钳咬除下颌骨过程中无一例发生明显出血，未发生面神经损伤、“第二下颌角”、升支骨折及感染等严重并发症。结论口内入路咬骨钳法矫正下颌角肥大畸形，操作简便，安全可靠，疗效满意，值得临床推广。

Objective To introduce a new technique for the correction of prominent mandibular angle correction by using a special designed bone rongeur. Methods Abrasive osteoplasty was performed on part of mandibula outer table using grinding burs under intraoral approach. The area of prominent mandibular angle which would be removed was marked by grinding burs, and then the prominent bone was removed by special designed bone rongeur. The sectional of mandible was polished. From August 2006 to October 2009, 128 patients were treated by this technique. Results After 1 -36 months follow-up, all 128 patients received satisfactory results except 2 cases with dissymmetry and 1 case with insufficiency bone removing, and the 3 cases healed after secondary repair. No obviously bleeding occurred during removing prominent mandibular angle through the bone rongeur. No such serious complications as facial nerve injury, forming secondary mandibular angle, ramus fracture and wound infection happened in this group. Conclusion It is a simple, safe and effective method for the correction of prominent mandibular angle with the special bone rongeur through intraoral approach. It is easy to operate and worth spreading in clinic.