下颌支矢状骨劈开术中下颌前突者下颌支的CT测量  

Significance of ramus measurement through computed tomography in the sagittal split osteotomy of the ramus

作　　者：马嘉[1] 李秉鸿[1] 卢利[1] 

机构地区：[1]中国医科大学口腔医学院,沈阳110002

出　　处：《中华整形外科杂志》2008年第5期353-356,共4页Chinese Journal of Plastic Surgery

摘　　要：目的用CT扫描的方法来描述下颌支骨松质分布和骨皮质厚度变化情况，以此来估计下颌支矢状骨劈开术舌侧骨切开的位置、深度和方向。方法45例实施下颌支矢状骨劈开术的骨性Ⅲ类下颌前突患者，术前进行上下颌骨CT扫描。从下颌小舌平面开始每隔2．5mm为一层面进行测量，向上20mm，在每一层面测量骨皮质的厚度和骨松质的分布情况。结果下颌支上部骨松质分开的占37．5％，骨松质在任何一层均未分开的占62．5％。在下颌小舌上5mm平面，舌侧骨皮质的厚度从前向后逐渐变薄，平均厚度1．55mm，下颌小舌距离升支后部骨皮质融合处的平均距离为9．45mm。结论舌侧骨切开应位于下颌小舌上5mm以内的区域，在下颌小舌后方9．45mm以内切开，骨切开线由后向前可轻度向下，切开深度2mm左右，向前逐渐加深。Objective To investigate significance of the distribution and thickness of cancellous and cortical bone in the mandibular ramus using computed tomography（CT） in the design of osteotomy at the medial aspect of the ramus. Methods 45 cases with class III prognathism underwent CT before operation. The distribution and thickness of cancellous and cortical bone in the mandibular ramus was measured every 2.5 mm thick from mandibular lingular plane to 20 mm above it. Results The upper ramus was separated by cancellous bone in only 37.5% of the cases. The other cases had no cancellous bone in the upper ramus. 5 mm above the lingual, the thickness of cortical bone at the lingual aspect decreased from the front to the behind with an average thickness of 1.55 mm. The distance from lingual to the fusion at the posterior border of ramus was 9.45 mm. Conclusions The medial cortical osteotomy should be located within 5 mm above the lingual and within 9.45 mm posterior to the lingular. The osteotomy could be slightly oblique and become deeper from behind to the front with an average depth of about 2 mm.

关 键 词：体层摄影术 螺旋计算机 骨松质 骨皮质 下颌支矢状骨劈开术 

分 类 号：R782.2[医药卫生—口腔医学] R816.98[医药卫生—临床医学]