保守治疗对儿童单侧髁突骨折患者颌骨对称性的影响

Effect of conservative treatment on jaw symmetry of children with unilateral condylar fracture

目的:探讨保守治疗对儿童单侧髁突骨折患者颌骨对称性的影响。方法:将24例2~13岁单侧髁突骨折患儿根据治疗方法分为对照组与试验组,每组12例。对照组接受牙弓夹板颌间牵引固定保守治疗,试验组接受颌间牵引联合垫保守治疗。比较2组的治疗效果、影像学改善情况、颌骨对称性、下颌运动功能及咬合关系紊乱、面神经损伤发生情况,采用SPSS 17.0软件包对数据进行统计学分析。结果:2组患者治疗后总有效率、影像学总有效率、咬合关系紊乱、面神经损伤发生率差异均无显著性(P>0.05)。试验组髁突横径显著长于对照组,试验组髁突宽度、骨性颏点偏斜显著小于对照组(P<0.05)。2组治疗后开口度均显著高于本组治疗前,试验组治疗后开口度显著大于对照组(P<0.05)。结论:儿童单侧髁突骨折患者采用颌间牵引联合垫保守治疗,可获得与牙弓夹板颌间牵引固定保守治疗相似的治疗效果,治疗后患儿下颌运动功能、颌骨对称性恢复良好。

PURPOSE:To investigate the effect of conservative treatment of unilateral condylar fractures on jaw symmetry in children.METHODS:Twenty-four children with unilateral condylar fractures were divided into control group and experimental group according to the treatment methods,with 12 cases in each group.The control group received surgery,and the experimental group received conservative treatment with intermaxillary traction combined with occlusal pads.The treatment effects of the two groups were compared,and the imaging improvement,three-dimensional structure of the jaw,mandibular motor and occlusal relationship,and facial nerve injury were compared after treatment.SPSS 17.0 software package was used for statistical analysis.RESULTS:There was no significant difference in the total effective rate,total effective rate of imaging,disturbance of occlusal relationship,and incidence of facial nerve injury between the two groups(P>0.05).The transverse diameter of the condyles was significantly longer in the experimental group than in the control group,and the width of the condyles and bony condylar deflection in the experimental group were significantly smaller than those in the control group(P<0.05).The degree of mouth opening after treatment in both groups was increased,which was more remarkably in the experimental group after treatment than in the control group(P<0.05).CONCLUSIONS:Children with unilateral condylar fractures can obtain similar treatment effects with surgical treatment with conservative treatment.After treatment,the children’s mandibular motor function and jaw symmetry are well restored.