内置式牵张成骨术与骨内牙种植体联合治疗火器伤性下颌骨缺损

Clinical application of internal distraction osteogenesis and endosseous dental in the reconstruction of mandibular defects resulted from firearm wound

目的:探讨内置式牵张成骨术与骨内牙种植体联合治疗火器伤性下颌骨缺损的临床应用可能性。方法:为1例火器伤性下颌骨缺损患者延期行内置式牵张成骨术,后期行骨内牙种植体植入和修复。术中常规截骨,制作骨转移盘,固定内置式骨牵张器,术后一周以每日1mm的速度行骨牵引,共牵引8mm。固定期大体,螺旋CT观察新骨生成及缺损修复状况。固定期4月行骨内牙种植体植入和后期修复。结果:治疗按计划完成,无感染等并发症发生,骨牵引顺利完成,新生骨骨质骨量良好,牙种植体骨整合良好,下颌骨缺损修复效果满意。结论:在早期合理清创基础上,延期内置牵张成骨术联合骨内牙种植体可有效地治疗火器伤性下颌骨缺损,值得推广。

Objective： To study the possibility of internal distraction osteogenesis and endosseous dental implant in the reconstruction of mandibular defects resulted from firearm wound.Methods： The later stage internal distraction osteogenesis and endosseous dental implant were performed on one patient who suffered from mandibular firearm would.In the operation,the bony transport disks were made and the internal distractors were installed.After a week of latency,the distraction started at a rate of 1mm per day,the distraction distance was 8mm.The process of bone formation and effect of deformity correction was studied by genenal observation and spiral CT.In the fourth month of consolidation,the endosseous dental implants were performed.Results： The patient and distractor were in good condition during the treatment.The bony transport disks were distracted as plan.The new bone well formed in the distraction gaps and the osseointegration of the dental implants was completed,reconstruction of mandibular defects was satisfied.Conclusion： On the basis of profit debridement in early stage,the mandibular firearm defects could be reconstructed by the internal distraction osteogenesis and endosseous dental implant effectively.It is worthy of recommended widely.