下颌骨升支矢状劈开截骨后下齿槽神经损伤的随访观察

为探讨双侧下颌骨升支矢状劈开截骨后下齿槽神经(IAN)暂时和永久性损伤的发生率和感觉恢复的时间,选择14例双侧下颌骨升支矢状劈开截骨的病例,在术前和术后1周、1个月、3个月、6个月和1年.采用针刺检测、两点分辨、直流感应电测法,确定 IAN 损伤的发生率和感觉恢复的时间。结果显示 IAN 暂时性损伤发生率为78%,永久性损伤为7%;暂时性损伤后需6～12个月感觉完全恢复。

Semmes-Weinstein单丝检测下颌骨矢状劈开截骨术后下牙槽神经功能的初步研究

目的:客观评价下颌失状劈开截骨术后下齿槽神经感觉障碍发生及自然恢复的发生率。方法:选择30例双侧下颌升支矢状截骨的患者在术前和术后1周、4周、2个月和6个月进行下齿槽神经感觉障碍的临床评价。30例患者均采用Semmes-Wei nst ei n单丝测试法。结果:术后7天感觉障碍发生率为100%。在所有检测区域,术后6个月的测量结果与术前最接近。6个月时20例患者感觉恢复术前水平。左右侧及性别间感觉障碍恢复优秀率的差异在各个随访时期均无统计学意义(P>O.05)。结论:BSSO术后早期感觉功能障碍较为普遍,然而在术后6个月,大多数患者的神经功能可达到自然恢复。

A Finite Element Analysis Study Comparing 3 Internal Fixation Techniques in Mandibular Sagittal Split Osteotomy

Purpose: To analyse, and compare using finite element analysis, the biomechanical properties of the 1.7 mm miniplate fixation against 2 conventional fixation techniques (2.0 mm bi-cortical screws and 2.0 mm miniplate) used in the mandibular sagittal split osteotomy. Methods: A 3-D virtual mandible model was constructed using images from CT scan. Sagittal split osteotomy was carried out virtually, and the fixation techniques were applied onto the model. 9 virtual models consisted of the 3 fixation techniques with mandibular movements of 3 mm setback, 3 mm advancement and 7 mm advancement were developed. Bite forces of 50, 75 and 100 N were applied for incisor bite simulation and 100, 200 and 300 N for molar biting force. Finite element analysis was carried out in Solidworks, and readings of stresses and displacement were recorded. Wilcoxon rank sum test was applied and P-value of 0.05 was set for statistical analysis. Results: In this manuscript the authors have compared 3 internal fixation techniques in mandibular sagittal split osteotomy. There was a statistically significant difference for both stress and displacement readings between the 1.7 mm miniplate, the 2.0 mm bi-cortical screws and the 2.0 mm miniplate for all mandibular movements. For the 1.7 mm miniplate vs 2.0 mm bi-cortical screws, the stress reading was (P = 3.063e-08, W = 314), and for displacement was (P = 5.811e-05, W = 282). For the 1.7 mm miniplate vs 2.0 mm miniplate, the stress reading was (P = 9.862e-4, W = 263) and for displacement was (2.05e-2, W = 235). Conclusion: The 1.7 mm miniplate has adequate strength to be used in mandibular sagittal split osteotomy, although statistically less rigid when compared to the conventional 2.0 mm miniplate and 2.0 mm bi-cortical screws, especially in larger movements.

双侧下颌升支矢状截骨下齿槽神经损伤和感觉恢复

目的 应用主观和客观测试神经感觉功能恢复的方法 ,检测双侧下颌升支矢状截骨(bilateralsagittalsplitosteotomy ,BSSO)后下齿槽神经 (inferioralveolarnerve ,IAN)暂时和永久性神经损伤的发生率和感觉恢复的时间。方法 选择 14例双侧下颌升支矢状截骨的IAN ,在术前和术后 7d ,1,3,6和 12个月采用针剌检测、两点分辨、直流感应电测法决定IAN的损伤和感觉的恢复。结果 IAN暂时性损伤率为 78% (2 2 2 8) ,单侧IAN永久性感觉丧失占 7% (2 2 8)。结论 IAN经损伤术后需 6～ 12个月感觉完全恢复 ,术中IAN断离可致永久性神经损伤。