发育性不对称畸形下颌骨生长活性的核素显像研究  

A Study on Developmental Activity of the Mandible in Mandibular Asymmetry Cases by Skeletal Scintigraphy

作　　者：高益鸣[1] 田伟家[2] 邱蔚六[3] 唐友盛[3] 沈国芳[3] 

机构地区：[1]上海交通大学医学院附属瑞金医院口腔科,上海200025 [2]上海交通大学医学院附属瑞金医院核医学科,上海200025 [3]上海交通大学医学院附属第九人民医院.口腔医学院口腔颌面外科,上海200011

出　　处：《口腔颌面外科杂志》2006年第3期222-225,共4页Journal of Oral and Maxillofacial Surgery

摘　　要：目的:研究下颌骨发育性不对称畸形患者髁突、下颌升支及下颌体生长活性的特征,为该类畸形患者手术时机及手术方案的选择提供参考。方法:对29例下颌骨发育性不对称畸形患者进行了下颌骨各部位99mTc-MDP吸收状况的测定,并以患者自身第4腰椎的吸收值作为参考以排除个体间差异。将病例分为大年龄组(≥20岁)和小年龄组(<20岁),其中大年龄组13例,小年龄组16例。对下颌骨髁突、升支、下颌体各部位的99mTc-MDP吸收比值进行统计学分析。结果:大年龄组下颌骨各区的吸收比值双侧无显著差异,个别患者在20岁以后仍显示出畸形区活跃的生长活性;小年龄组双侧髁突区吸收比值差异显著(P<0.05);检测结果显示下颌骨发育不良侧与正常侧无显著差异;而发育过度侧与正常侧及发育不良侧的差异显著。结论:在20岁以前发育性下颌骨不对称畸形大部分处于快速发展阶段,20岁以后趋于平稳;少数病例在20岁以后其畸形的下颌骨在髁突区仍有活跃生长的现象。下颌骨不对称畸形的手术治疗,术前可以通过核素显像检查确定非正常发育是否停止来决定手术时机的选择。Objective： To study the developmental characters of the asymmetric mandibular condyle, ramus and mandibular body for election of orthognathic operation time and the treatment methods to the mandibular asymmetry cases. Methods： Twenty-nine cases of developmental mandibular asymmetry were divided into two groups, the adults group （older than 20 years old,13 cases） and the adolescents group （younger than 20 years old, 16 cases）. ^9omTc-MDP bone uptake ratios of three regions of the mandible were analyzed in all cases. Results： The results showed that there was high activity of asymmetric growth in the mandible of adolescent group. The hyperactivity of most asymmetric mandible was stabilized in adult group. In some cases the asymmetric growth was not ceased concurrently with the growth finish of whole body. In the cases with hypogenetic mandible, there was no significant difference between the normal and abnormal side in both groups. While there was significant difference between the normal and abnormal sides in the cases of mandibular hyperplasia. Conclusion： There is high activity of asymmetric growth in the mandible before 20 years old. The hyperactive of majority asymmetric mandible would be stabilized after the age of 20. In some cases the asymmetric growth was not ceased concurrently with the growth finish of whole body. Skeletal scintigraphy can be taken to determine whether asymmetric growth is in progress or had ceased before the orthognathic surgery, for the mandibular asymmetry cases.

关 键 词：下颌骨 不对称 核素 骨闪烁照相法 

分 类 号：R782[医药卫生—口腔医学] R817.4[医药卫生—临床医学]