颌间牵引钉联合小型或微型钛板内固定修复颌骨骨折

Internal fixation with intermaxillary traction nail combined with small/mini-titanium plate in the treatment of mandibular fractures

背景:颌骨骨折常对患者工作生活造成严重影响,颌间牵引钉联合微型钛板相对于传统的牙弓夹板联合小型或微型钛板单独治疗,存在治疗时间短、固定效果好等优点,能帮助颌骨骨折患者改善所受颌面部等功能障碍,助其早日完成治疗。目的:通过试验颌间牵引钉联合微型钛板内固定相对牙弓夹板联合小型或微型钛板治疗的优势,探究其对于颌骨骨折的疗效及其应用效果。方法:选取2011年7月至2015年5月在西南医科大学附属口腔医院颌面外科住院治疗的颌骨骨折患者90例,随机分为对照组和观察组,每组各45例。对照组使用牙弓夹板联合小型或微型钛板内固定治疗,观察组采用颌间牵引钉联合小型或微型钛板内固定治疗。观察4-6个月。对比两组疗效,按照显效、有效及总有效率评价,观察各项颌面部功能,以及治疗后不良反应发生率,总结分析试验数据,评判其应用价值。结果与结论:1总有效率:观察组总有效率、各项颌面部功能明显优于对照组(P<0.05);2两组患者牙周情况对照组治疗前后菌斑和软垢指数的上升程度明显高于观察组(P<0.05);治疗前后,观察组牙龈指数无显著变化,但对照组有明显上升(P<0.05);3不良反应发生例数:观察组明显少于对照组(P<0.05);4结果证实:颌间牵引钉联合小型或微型钛板内固定修复颌骨骨折效果较好,安全可靠。

BACKGROUND： Mandibular fractures often harm patient＇s work and life. Intermaxillary traction nail with small/mini-titanium plate, relative to traditional dental arch splint combined with small/mini titanium plate treatment alone, is characterized by short treatment time and good fixation effect, which can improve the maxillofacial dysfunction and promote the early completion of the treatment.OBJECTIVE： To explore the curative effect of intermaxillary traction nail with mini-titanium plate versus dental arch splint combined with small/mini-titanium plate on mandibular fractures METHODS： Ninety cases of mandibular fractures hospitalized at the Department of Oral and Maxillofacial Surgery, Stomatological Hospital of Southwest Medical University in China from July 2011 to May 2015 were enrolled in this study. These patients were equivalently randomized into control group subjected to dental arch splint combined with small/mini-titanium plate and observation group subjected to intermaxillary traction nail with mini-titanium plate. All the patients were followed up for 4-6 months. Curative effects, including excellent and good rate and total efficiency, were compared between the two groups. Maxillofacial function and incidence of adverse reactions were observed and recorded, respectively, to analyze the experimental data and assess their clinical values. RESULTS AND CONCLUSION： The total efficiency and the maxillofacial function were significantly better in the observation group than the control group（P〈0.05）. Plaque and debris index was increased significantly in the control group compared with the experimental group before and after treatment（P〈0.05）. The gingival index had no significant changes in the observation, but it was increased significantly in the control group before and after treatment（P〈0.05）. The number of cases of adverse reactions was significantly less in the experimental group than the control group（P〈0.05）. These results show that the effect of internal fixation with intermaxillary traction nail combined with small/mini-titanium plate mini titanium plate and mini titanium plate was good, safe and reliable.