钛板对儿童下颌骨生长发育影响的长期随访研究

Long-term follow-up study of titanium implant impact on pediatric mandibular growth and development

目的通过对比下颌骨骨折术后取出和未取出钛板钛钉的患者生长发育情况,探讨钛板钛钉对患者下颌骨生长发育的影响。方法对行下颌骨手术切开复位坚强内固定术的15例儿童患者进行回顾性研究,根据术后是否取出钛板钛钉分为取钛板组(7例)和未取钛板组(8例),对患者进行病历收集、术后随访、临床专科检查及影像学测量,比较分析2组患者的容貌形态及影像学资料。结果 15例患者的外形和功能恢复基本满意,未见明显异常,影像学测量表明2组患者左右侧下颌骨长度之差的差异无统计学意义(P>0.05)。结论钛板钛钉植入对儿童下颌骨的生长发育无明显影响,鉴于二次手术钛板取出可能造成的再次创伤,术后钛板取出术可不常规实施。

Objective To explore the impact of titanium implant on the growth and development of pediatric mandible after suffering from mandibular fracture and undergoing open reduction and internal fixation（ORIF） compared with those that underwent titanium plate removal postoperatively. Methods Fifteen pediatric patients with mandibular fracture who underwent ORIF were included in this study. Eight patients did not undergo titanium implant removal postoperatively, whereas the other seven patients underwent the routine. The postoperative data of the pediatrics were collected for comparative analysis by taking the patients＇ frontal and lateral photos, recording the inter-incisor distance, and measuring the height of mandibular ramus, length of the mandibular body, and combined length of the mandible in three-dimensional reconstruction image. Results All patients had acceptable facial contour, mouth opening, and occlusion, without obvious abnormalities. The radiography showed no significant difference between the bilateral mandibular lengths in the two groups of patients（P0.05）. Conclusion The titanium plants have no significant impact on the growth and development of pediatric mandible postoperatively; hence, the question on whether the titanium plates should be removed or not may be neglected. The removal operation may lead to secondary trauma; thus, performing titanium plate removal routinely is not recommended.