钛钉颌间牵引固定配合弹力帽辅助固定法治疗下颌骨骨折的临床研究

Clinical research on the titanium nail mandibular fixation combined with elastic cap?assisted fixation in the treatment of mandibular fracture

目的 比较传统的牙弓夹板颌间固定、微钛板内固定加钛钉颌间牵引和钛钉颌间固定配合弹力帽辅助固定3种治疗方法治疗下颌骨骨折的临床效果。方法 选择2016年7月至2017年12月于上海市奉贤区奉城医院就诊的非复杂性下颌骨骨折患者60例作为研究对象,随机分为A、B、C 3组,每组20例。A组采用钛钉颌间固定配合弹力帽辅助固定;B组采用牙弓夹板颌间固定;C组采用微钛板内固定加钛钉颌间牵引。分别比较临床疗效、软垢指数(debris index,DI)、牙龈指数(gingival index,GI)和社区牙周治疗量表指数(community periodontal therapy index,CPITN)、操作时间、花费等指标。结果 A、C组总有效率均显著高于B组(P<0.05)。治疗前,3组患者的DI、GI和CPITN评分差异无统计学意义(P>0.05)。治疗后,A、C组患者DI、GI和CPITN评分均显著低于B组(P<0.05)。结论 钛钉颌间固定配合弹力帽辅助固定法的临床有效率、各项口腔卫生指标显著高于传统牙弓夹板颌间固定法,且成本显著低于微钛板内固定联合钛钉颌间牵引法,体现出良好的临床应用前景。

Objective To compare the efficacy of 3 treatment methods including traditional arch splint maxillary fixation,mi?cro?titanium plate internal fixation+titanium nail mandibular traction and titanium nail mandibular fixation combined with elastic cap?assisted fixation.Methods Sixty patients with non?complex mandibular fractures admitted into hospital for treatment from July 2016 to December 2017 were recruited and randomly divided into 3 groups,each consisting of 20 patients.Group A received titanium nail man?dibular fixation+elastic cap auxiliary fixation,group B had arch splint and jaw fixation,and group C adopted micro?titanium plate in?ternal fixation+titanium nail mandibular traction.Clinical therapeutic effects,debris indexes(DI),gingival indexes(GI)and com?munity periodontal therapy indexes(CPITN),operation time,medical costs,as well as other indexes were compared between the 3 groups.Results Total efficacy rates of group A and group C were significantly higher than that of group B(P<0.05).Before treat?ment,there were no significant statistical differences in the DI,GI and CPITN scores in the 3 groups(P>0.05).However,after treat?ment,the DI,GI and CPITN scores of the patients in groups A and C were significantly lower than those of the patients in group B(P<0.05).Conclusion The clinical efficiency and various oral hygiene indexes of the titanium nail mandibular fixation combined with elastic cap?assisted fixation were significantly superior to those of the traditional dental arch splint.Furthermore,the cost involved was significantly lower than that of the micro?titanium plate internal fixation combined with titanium nail mandibular traction,which promises good future clinical application.