Objective:To analyze the effectiveness of personalized 3D-printed rehabilitation orthotics in the postoperative recovery of jaw fractures.Methods:Relevant data were collected from 42 patients with jaw fractures treate...Objective:To analyze the effectiveness of personalized 3D-printed rehabilitation orthotics in the postoperative recovery of jaw fractures.Methods:Relevant data were collected from 42 patients with jaw fractures treated at our hospital between October 2017 and May 2020.Patients were randomly divided into a traditional group(n=17)and a modified group(n=25).The traditional group received standard rehabilitation methods,while the modified group used personalized 3D-printed rehabilitation orthotics combined with improved rehabilitation methods.The temporomandibular disability index(TDI),quality of life scores,postoperative recovery excellence rate,and mouth opening were compared between the two groups at different follow-up times(before rehabilitation,and at 1 week,3 months,and 6 months post-surgery).Results:At 1 week,3 months,and 6 months post-surgery,the TDI in both the traditional and modified groups was significantly lower than before rehabilitation,with statistically significant differences(P<0.05).At 3 and 6 months post-surgery,the TDI in the modified group was lower than in the traditional group,with statistically significant differences(P<0.05).At 3 and 6 months post-surgery,pain,appearance,activity,recreation,work,chewing,swallowing,speech,shoulder function,and total quality of life scores in both groups were higher than before rehabilitation,with the modified group showing significantly higher scores in pain,appearance,chewing,swallowing,and total quality of life(P<0.05).Compared to before rehabilitation,mouth opening significantly improved in both groups at 3 and 6 months post-surgery,with the modified group showing significantly greater improvement(P<0.05).Conclusion:Personalized 3D-printed rehabilitation orthotics are highly effective in the postoperative recovery of jaw fractures.They can improve patients’quality of life after surgery,enhance the excellent rate of postoperative recovery,and increase mouth opening.展开更多
Purpose:This study evaluated the methods and clinical effects of multidisciplinary collaborative treatment for occlusal reconstruction in patients with old jaw fractures and dentition defects.Methods:Patients with old...Purpose:This study evaluated the methods and clinical effects of multidisciplinary collaborative treatment for occlusal reconstruction in patients with old jaw fractures and dentition defects.Methods:Patients with old jaw fractures and dentition defects who underwent occlusal reconstruction at the Third Affiliated Hospital of Air Force Military Medical University from January 2018 to December 2022 were enrolled.Clinical treatment was classified into 3 phases.In phase I,techniques such as orthognathic surgery,microsurgery,and distraction osteogenesis were employed to reconstruct the correct 3-dimensional(3D)jaw position relationship.In phase II,bone augmentation and soft tissue management techniques were utilized to address insufficient alveolar bone mass and poor gingival soft tissue conditions.In phase III,implant-supported overdentures or fixed dentures were used for occlusal reconstruction.A summary of treatment methods,clinical efficacy evaluation,comparative analysis of imageological examinations,and satisfaction questionnaire survey were utilized to evaluate the therapeutic efficacy in patients with traumatic old jaw fractures and dentition defects.All data are summarized using the arithmetic mean±standard deviation and compared using independent samplet-tests.Results:In 15 patients with old jaw fractures and dentition defects(an average age of 32 years,ranging from 18 to 53 years),there were 7 cases of malocclusion of single maxillary fracture,6 of malocclusion of single mandible fracture,and 2 of malocclusion of both maxillary and mandible fractures.There were 5 patients with single maxillary dentition defects,2 with single mandibular dentition defects,and 8 with both maxillary and mandibular dentition defects.To reconstruct the correct 3D jaw positional relationship,5 patients underwent Le Fort I osteotomy of the maxilla,3 underwent bilateral sagittal split ramus osteotomy of the mandible,4 underwent open reduction and internal fixation for old jaw fractures,3 underwent temporomandibular joint surgery,and 4 underwent distraction osteogenesis.All patients underwent jawbone augmentation,of whom 4 patients underwent a free composite vascularized bone flap(26.66%)and the remaining patients underwent local alveolar bone augmentation.Free gingival graft and connective tissue graft were the main methods for soft tissue augmentation(73.33%).The 15 patients received 81 implants,of whom 11 patients received implant-supported fixed dentures and 4 received implant-supported removable dentures.The survival rate of all implants was 93.82%.The final imageological examination of 15 patients confirmed that the malocclusion was corrected,and the clinical treatment ultimately achieved occlusal function reconstruction.The patient satisfaction questionnaire survey showed that they were satisfied with the efficacy,phonetics,aesthetics,and comfort after treatment.Conclusion:Occlusal reconstruction of old jaw fractures and dentition defects requires a phased sequential comprehensive treatment,consisting of 3D spatial jaw correction,alveolar bone augmentation and soft tissue augmentation,and implant-supported occlusal reconstruction,achieving satisfactory clinical therapeutic efficacy.展开更多
The article evaluates 12 cases of conservative treatment of displaced mandibular fractures in adults. Twelve cases of displaced mandibular fractures treated surgically, either by closed reduction (IMF) or open reducti...The article evaluates 12 cases of conservative treatment of displaced mandibular fractures in adults. Twelve cases of displaced mandibular fractures treated surgically, either by closed reduction (IMF) or open reduction internal fixation (ORIF) served as controls. Occlusion, maximal mouth opening, lateral jaw movements, neurological dysfunction (=sensory deficit), and bone remodeling were evaluated and scored in both groups, and results were compared. No significant differences were found between the two groups in all the evaluated parameters. It is concluded that in certain cases, with displacement of 2 - 4 mm, where a surgical approach is not feasible, reasonable spontaneous reduction and bone remodeling can occur. Meticulous follow-up is mandatory.展开更多
磁场是一种安全、无创的物理治疗方法。大量研究证实磁场具有良好的成骨效应,在加速正畸牙移动、促进种植体骨整合、促进骨折愈合和提高牵张成骨效果等方面有一定的临床应用价值,有望成为治疗口腔疾病的一种有效辅助手段。为更好地将磁...磁场是一种安全、无创的物理治疗方法。大量研究证实磁场具有良好的成骨效应,在加速正畸牙移动、促进种植体骨整合、促进骨折愈合和提高牵张成骨效果等方面有一定的临床应用价值,有望成为治疗口腔疾病的一种有效辅助手段。为更好地将磁场应用于临床,本文就磁场在口腔领域的应用、对骨组织细胞的生物学效应和磁场调控骨代谢的分子机制三方面进行综述。磁场对骨组织细胞的生物学效应主要体现为促进成骨细胞和间充质干细胞的成骨,降低骨细胞的凋亡率,对破骨细胞的影响则尚无定论。在分子层面,骨组织细胞感应并响应磁刺激,磁信号经位移电流、洛伦磁力和自由基对效应等机制转变为生物可识别的电信号,进而激活下游P2嘌呤能受体、腺苷受体信号通路、转化生长因子-β受体信号通路、哺乳动物雷帕霉素靶蛋白(mammalian target of rapamycin,m TOR)和Notch通路等信号网络。此外,本文还探讨了影响磁场成骨效应的因素——磁场参数,以期为临床医生提供参考。然而,磁场成骨效应的作用机制目前尚未明确,继续深入研究磁场的作用机制可为骨组织再生和牙周组织再生提供有效策略。另外,聚焦磁场的作用靶点,将磁场与其他药物联合应用,可为口腔疾病的治疗提供新思路。展开更多
基金Open Subject of Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases,College of Stomatology,Xi’an Jiaotong University(Project No.2011YHJB08)。
文摘Objective:To analyze the effectiveness of personalized 3D-printed rehabilitation orthotics in the postoperative recovery of jaw fractures.Methods:Relevant data were collected from 42 patients with jaw fractures treated at our hospital between October 2017 and May 2020.Patients were randomly divided into a traditional group(n=17)and a modified group(n=25).The traditional group received standard rehabilitation methods,while the modified group used personalized 3D-printed rehabilitation orthotics combined with improved rehabilitation methods.The temporomandibular disability index(TDI),quality of life scores,postoperative recovery excellence rate,and mouth opening were compared between the two groups at different follow-up times(before rehabilitation,and at 1 week,3 months,and 6 months post-surgery).Results:At 1 week,3 months,and 6 months post-surgery,the TDI in both the traditional and modified groups was significantly lower than before rehabilitation,with statistically significant differences(P<0.05).At 3 and 6 months post-surgery,the TDI in the modified group was lower than in the traditional group,with statistically significant differences(P<0.05).At 3 and 6 months post-surgery,pain,appearance,activity,recreation,work,chewing,swallowing,speech,shoulder function,and total quality of life scores in both groups were higher than before rehabilitation,with the modified group showing significantly higher scores in pain,appearance,chewing,swallowing,and total quality of life(P<0.05).Compared to before rehabilitation,mouth opening significantly improved in both groups at 3 and 6 months post-surgery,with the modified group showing significantly greater improvement(P<0.05).Conclusion:Personalized 3D-printed rehabilitation orthotics are highly effective in the postoperative recovery of jaw fractures.They can improve patients’quality of life after surgery,enhance the excellent rate of postoperative recovery,and increase mouth opening.
基金Project of State Key Laboratory of Military Stomatology(2021ZA07)Shaanxi Provincial Key Research and Development Program(2023-YBSF-291)The Science and Technology Project of Xi'an City(22YXYJ0116).
文摘Purpose:This study evaluated the methods and clinical effects of multidisciplinary collaborative treatment for occlusal reconstruction in patients with old jaw fractures and dentition defects.Methods:Patients with old jaw fractures and dentition defects who underwent occlusal reconstruction at the Third Affiliated Hospital of Air Force Military Medical University from January 2018 to December 2022 were enrolled.Clinical treatment was classified into 3 phases.In phase I,techniques such as orthognathic surgery,microsurgery,and distraction osteogenesis were employed to reconstruct the correct 3-dimensional(3D)jaw position relationship.In phase II,bone augmentation and soft tissue management techniques were utilized to address insufficient alveolar bone mass and poor gingival soft tissue conditions.In phase III,implant-supported overdentures or fixed dentures were used for occlusal reconstruction.A summary of treatment methods,clinical efficacy evaluation,comparative analysis of imageological examinations,and satisfaction questionnaire survey were utilized to evaluate the therapeutic efficacy in patients with traumatic old jaw fractures and dentition defects.All data are summarized using the arithmetic mean±standard deviation and compared using independent samplet-tests.Results:In 15 patients with old jaw fractures and dentition defects(an average age of 32 years,ranging from 18 to 53 years),there were 7 cases of malocclusion of single maxillary fracture,6 of malocclusion of single mandible fracture,and 2 of malocclusion of both maxillary and mandible fractures.There were 5 patients with single maxillary dentition defects,2 with single mandibular dentition defects,and 8 with both maxillary and mandibular dentition defects.To reconstruct the correct 3D jaw positional relationship,5 patients underwent Le Fort I osteotomy of the maxilla,3 underwent bilateral sagittal split ramus osteotomy of the mandible,4 underwent open reduction and internal fixation for old jaw fractures,3 underwent temporomandibular joint surgery,and 4 underwent distraction osteogenesis.All patients underwent jawbone augmentation,of whom 4 patients underwent a free composite vascularized bone flap(26.66%)and the remaining patients underwent local alveolar bone augmentation.Free gingival graft and connective tissue graft were the main methods for soft tissue augmentation(73.33%).The 15 patients received 81 implants,of whom 11 patients received implant-supported fixed dentures and 4 received implant-supported removable dentures.The survival rate of all implants was 93.82%.The final imageological examination of 15 patients confirmed that the malocclusion was corrected,and the clinical treatment ultimately achieved occlusal function reconstruction.The patient satisfaction questionnaire survey showed that they were satisfied with the efficacy,phonetics,aesthetics,and comfort after treatment.Conclusion:Occlusal reconstruction of old jaw fractures and dentition defects requires a phased sequential comprehensive treatment,consisting of 3D spatial jaw correction,alveolar bone augmentation and soft tissue augmentation,and implant-supported occlusal reconstruction,achieving satisfactory clinical therapeutic efficacy.
文摘The article evaluates 12 cases of conservative treatment of displaced mandibular fractures in adults. Twelve cases of displaced mandibular fractures treated surgically, either by closed reduction (IMF) or open reduction internal fixation (ORIF) served as controls. Occlusion, maximal mouth opening, lateral jaw movements, neurological dysfunction (=sensory deficit), and bone remodeling were evaluated and scored in both groups, and results were compared. No significant differences were found between the two groups in all the evaluated parameters. It is concluded that in certain cases, with displacement of 2 - 4 mm, where a surgical approach is not feasible, reasonable spontaneous reduction and bone remodeling can occur. Meticulous follow-up is mandatory.
文摘磁场是一种安全、无创的物理治疗方法。大量研究证实磁场具有良好的成骨效应,在加速正畸牙移动、促进种植体骨整合、促进骨折愈合和提高牵张成骨效果等方面有一定的临床应用价值,有望成为治疗口腔疾病的一种有效辅助手段。为更好地将磁场应用于临床,本文就磁场在口腔领域的应用、对骨组织细胞的生物学效应和磁场调控骨代谢的分子机制三方面进行综述。磁场对骨组织细胞的生物学效应主要体现为促进成骨细胞和间充质干细胞的成骨,降低骨细胞的凋亡率,对破骨细胞的影响则尚无定论。在分子层面,骨组织细胞感应并响应磁刺激,磁信号经位移电流、洛伦磁力和自由基对效应等机制转变为生物可识别的电信号,进而激活下游P2嘌呤能受体、腺苷受体信号通路、转化生长因子-β受体信号通路、哺乳动物雷帕霉素靶蛋白(mammalian target of rapamycin,m TOR)和Notch通路等信号网络。此外,本文还探讨了影响磁场成骨效应的因素——磁场参数,以期为临床医生提供参考。然而,磁场成骨效应的作用机制目前尚未明确,继续深入研究磁场的作用机制可为骨组织再生和牙周组织再生提供有效策略。另外,聚焦磁场的作用靶点,将磁场与其他药物联合应用,可为口腔疾病的治疗提供新思路。
