牵引钉植入与牙弓夹板行颌间牵引固定治疗单纯髁状突骨折的疗效比较

A comparative study on the curative effect between pulling nail and arch splint for the intermaxillary traction of simply mandibular condylar fracture

目的比较两种颌间牵引固定方法治疗单纯髁状突骨折的临床疗效。方法将单纯髁状突骨折的患者随机分成牵引钉植入组(23例)和牙弓夹板组(21例),并行相应的颌间牵引固定治疗,分别检测两组术后患者的咬合关系恢复情况、操作时间的长短以及在五个不同时间点测定的DI、GI、CPITN指数,对二组在疗效、操作的难易和牙周状况的变化进行比较。结果牵引钉植入术与牙弓夹板行颌间牵引固定均能达到较好的临床治疗效果,在术后最大开口度及颞下颌关节检查方面无统计学意义(P>0.05),但使用牵引钉植入操作时间明显缩短(P<0.05),且颌间牵引治疗期间及颌间牵引装置拆除后,两组在DI、GI及CPITN方面的差异有统计学意义(P<0.05)。结论牵引钉植入术是一种新的微创、快捷、安全有效的治疗髁状突骨折的方法,值得在临床上推广使用。

Objective To compare and evaluate the clinical efficacy of the application of two types of the intermaxillary elastic trac- tion used in the simply mandibular condylar fracture. Methods Patients who suffered from simply mandibular condylar fracture were randomly divided into pulling nall implantation group （group A,23 patients） and arch splint group （group B,21 patients）. The occlu- sion relationship,the time of operation and DI,GI, CPITN indexes were tested. Healing efficacy of these two methods, and the difficulty of operation as well as changes of periodontal status of two groups were compared. Results Group A and group B both achieved good clinical efficacy,and the differences in the maximum opening degree and temporomandibular joint between two groups were not statisti- cally significant,but group B had the advantage of shorter operation time （P 〈 0.05 ）. The differences in DI, GI, CPITN indexes were statistically significant during and after intermaxillary traction （P 〈 0.05）. Conclusions It can be concluded that pulling nail implan- tation is a new minimally invasive,time-saving,safe and reliable therapy of the simply mandibular condylar fracture. It is worth exten- ding for its clinical application.