口内入路两种方法下颌角修整术矫正脸型的临床应用

Clinical application of two intra-oral approach methods for reduction mandibuloplasty on mandibular angle

目的:探讨经口内入路不同术式矫正下颌宽大的适应证及疗效。方法:对85例下颌宽大患者随机分为两组,均采用口内入路。A组43例,全部采用摆动锯进行下颌角截骨术。B组42例,全部采用磨骨法磨除下颌角。结果:磨骨组患者较截骨组肿胀轻,恢复快。磨骨组术中出血少于截骨组。随访6个月～1年,下颌骨正位片测量显示两组患者的下颌角间距和面下三分之一宽度均变小,两组满意率均较高。结论:截骨法和磨骨法均能达到矫正面型的满意效果,但2型(外翻型下颌角)采用磨骨法较好,1型(后下突出型下颌角)和3型(复合型)截骨法效果更好。

Objective To discuss the indication and effects of different reduction mandibuloplasty methods correcting broad mandibular by intra-oral approach.Methods 85 cases were randomly divided into two groups,all unsing intra-oral approach.Group A had 43 patients whose underwent ostectomy of mandible angle by oscillating saw.Group B had 42 patients whose underwent reduction mandibuloplasty by grinding.Results Compared with Group A,Group B had a slighter swelling,shorter recovery period and less bleeding.By 6 months to 1 year follow-up,the cephalometric anteroposterior images showed both the bigonial distance and lower face width were reduced,and both groups had a high satisfaction rate.Discussion Both ostectomy and grinding of mandibular angle could achieving satisfactory effects.However the type 2（Ectropion mandibular angle）had better effects on grinding method,Type 1（Posteroinferior herniation mandibular angle） and type 3（Compound of 1 and 2） achieved better effects with ostectomy.