下颌骨多发性骨折一期手术失败后的二期治疗  

The second period-treatment for mandible multiple outmoded fracture after operation failure

作　　者：刘奕[1] 毕玮玮[1] 郐滨[1] 

机构地区：[1]中国医科大学口腔医学院正畸科,辽宁沈阳110002

出　　处：《临床口腔医学杂志》2009年第1期43-44,共2页Journal of Clinical Stomatology

摘　　要：目的:探讨在模型外科指导下,对下颌骨多发性骨折一期手术失败病例进行二期治疗。方法:术前行模型外科,制作板,常规置牙弓夹板或粘结全口方丝弓托槽。采用口内切口,手术切开后显露陈旧骨折线,清理陈旧性骨痂及在骨折线周围移除嵌顿的软组织,拆除原固定用钛板,戴上术前制作好的板,确定咬合关系后重新行钛板坚固内固定。术后颌间牵引2周。去除板及牙弓夹板,嘱患者行开口训练。结果:患者咬合关系完全恢复正常。结论:通过模型外科,术中板引导,钛板坚固内固定结合术后颌间牵引治疗一期手术失败的下颌骨多发性骨折,有利于术后咬合关系的恢复,临床应用效果好。Objective： To investigate the way of the second period-treatment for mandible outmoded fracture on the basis of model surgery. Method： Before the surgery, we carried out model surgery, made occlusion guide plate, and routinely placed dental arch splints. The surgery chose internal incision. In surgery, at first,we revealed the outmoded fracture line. Secondly, cleared bony callus and removed soft tissue around the outmoded fracture line .Thirdly, got rid of the old pates, placed the occlusion guide plate made before the surgery to recover bite relation of pre-injure. Eventually all patients were taken rigid internal fixation with new plate. After the operation the intermaxillary elastics were maintained for 2 weeks, and patients were told to make training in opening and closing mouth regularly. Result： All patients＇bite relations absolutely re- cover. Conclusion： On the conduction of model surgery and the occlusion guide plate, the rigid internal fixation with inter- maxillary elastics to treat mandible outmoded fracture is good for union of fracture and recovery of the bite relation. The effects of clinical application are satisfactory.

关 键 词：下颌骨骨折 模型外科 [牙合]板 

分 类 号：R782.4[医药卫生—口腔医学]