钛钉颌间牵引固定术联合弹力帽辅助固定法治疗下颌骨骨折患者的效果

Effects of titanium screw intermaxillary traction fixation combined with elastic cap assisted fixation in treatment of patients with mandibular fractures

目的:观察钛钉颌间牵引固定术联合弹力帽辅助固定法治疗下颌骨骨折患者的效果。方法:回顾性分析2019年1月至2021年1月南阳市口腔医院收治的82例下颌骨骨折患者的临床资料,将以牙弓夹板颌间牵引固定术治疗的41例患者纳入对照组,将以钛钉颌间牵引固定术联合弹力帽辅助固定法治疗的41例患者纳入观察组。比较两组临床疗效,术前和术后3、6周口腔卫生指标[牙龈指数(GI)、软垢指数(DI)、社区牙周治疗需要指数(CPITN)]水平,术前和术后12 h创伤应激指标[去甲肾上腺素(NE)、血管紧张素Ⅱ(AngⅡ)、皮质醇(Cor)]水平,以及并发症发生率。结果:观察组治疗总有效率为95.12%(39/41),高于对照组的75.61%(31/41),差异有统计学意义(P<0.05);术后3、6周,观察组GI、DI和CPITN评分均低于对照组,差异有统计学意义(P<0.05);术后12 h,观察组血清NE、Cor和AngⅡ水平均低于对照组,差异有统计学意义(P<0.05);两组并发症发生率比较,差异无统计学意义(P>0.05)。结论:相较于牙弓夹板颌间牵引固定术治疗,钛钉颌间牵引固定术联合弹力帽辅助固定法治疗下颌骨骨折患者可提高治疗总有效率,且对口腔卫生指标和创伤应激指标的影响较小。

Objective:To observe effects of titanium screw intermaxillary traction fixation combined with elastic cap assisted fixation in treatment of patients with mandibular fractures.Methods:The clinical data of 82 patients with mandibular fractures admitted to our hospital from January 2019 to January 2021 were retrospectively analyzed.Among them,41 patients treated with dental arch splint intermaxillary traction fixation were chosen as control group,and 41 patients treated with titanium screw intermaxillary traction fixation combined with elastic cap assisted fixation were included in observation group.The clinical efficacy,the oral hygiene index levels[gingival index(GI),soft diposits index(DI),community periodontal index for treatment need(CPITN)]before and 3 and 6 weeks after the surgery,the traumatic stress indicator levels before and 12 hours after the surgery[norepinephrine(NE),angiotensinⅡ(AngⅡ),cortisol(Cor)],and the incidence of complications were compared between the two groups.Results:The total effective rate of treatment in the observation group was 95.12%(39/41),which was higher than the control group of 75.61%(31/41),and the difference was statistically significant(P<0.05).3 and 6 weeks after the surgery,the GI,DI and CPITN scores of the observation group were lower than those of the control group,and the differences were statistically significant(P<0.05).12 hours after the surgery,the serum levels of NE,Cor and Ang II in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).However,there was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusions:Compared with dental arch splint intermaxillary traction fixation,titanium screw intermaxillary traction fixation combined with elastic cap assisted fixation in the treatment of the patients with mandibular fractures can improve the total effective rate of treatment,and has a little effects on the levels of oral hygiene indexes and traumatic stress indicators.