应用重建接骨板拓形的临床意义  

Clinic significance of application of reconstruction plate figuration.

作　　者：胡晓光 程晓兵 杨耀武 张明 张圃 雷德林 

机构地区：[1]第四军医大学口腔医院颌面外科,陕西西安710032

出　　处：《现代肿瘤医学》2005年第3期355-356,共2页Journal of Modern Oncology

摘　　要：目的探讨在下颌骨缺损的修复过程中,如何应用重建接骨板进行较准确的拓形即保持或恢复原有的外形和咬合关系。方法便于临床操作和易于描述,将下颌骨缺损分为Ⅳ类。Ⅰ类:颏部及部分下颌骨体部缺损;Ⅱ类:一侧下颌骨体部及少部分升支部缺损;Ⅲ类:一侧下颌骨体部和全部同侧升支,包括仅留髁状突的截骨;Ⅳ类:保留双侧升支的下颌骨截骨。不同类型缺损的植骨以及固定方法有所不同,此过程对咬合关系的恢复有一定的影响。结果38例患者术后,34例咬合关系均恢复良好,2例仍需进行颌间牵引,1例植骨时造成升支过长,1例患者因感染在术后3周摘除植骨块和重建板。结论下颌骨重建包括两个方面,即咬合关系和外形,咬合关系的恢复充分体现了功能重建的内涵。重建接骨板的合理应用可以较好的拓出原有的咬合关系和外形。Objective To discuss how to use reconstruction plate for accurate figuration and keep or restore original form and occlusion in the repair of mandible defect. Methods In order to be convenient for clinic operation and description, mandible defect was divided to 4 classes. Class 1: metal and partly mandible body defect; Class 2: one side of mandible body and part of ramus defect; Class 3: one side of mandible body and all ramus defect; Class 4: only ramus of both sides was reserved. The method of bone graft and fixation was quite different and also influence the recover of occlusion.Results Of 38 patients underwent operation, occlusion relation were restored in 34 cases. Intermaxilary distraction was still needed in 1 case; ramus was too long because of bone graft in 1 case; the reconstruction plate and graft bone were forced to be taken off in 1 infected case. Conclusion Reconstruction of mandible included 2 aspects, occlusion relation and facial shape. The sole of functional reconstruction was completely incarnated by restoration of occlusion relation. Original occlusion relation and facial shape could be perfectly formed by reasonable application of reconstruction plate.[

关 键 词：下颌骨 缺损 重建板 

分 类 号：R739.91[医药卫生—肿瘤]