超声骨切割技术在正颌外科中的应用  

Piezoelectric Surgery(Piezosurgery) in Orthognathic Surgery

作　　者：林润台[1] 宿玉成[1] 戈怡[1] 任燕玲[1] 

机构地区：[1]中国医学科学院北京协和医院口腔科,北京100032

出　　处：《口腔医学研究》2009年第6期764-765,共2页Journal of Oral Science Research

摘　　要：目的：与传统骨切割技术对比,探讨超声骨切割技术在正颌外科应用中的安全性和有效性。方法：本组病例12例,其中男2例,女10例;20～65岁;双颌畸形7例,上颌后缩3例,下颌前突2例;行Le FortⅠ型截骨术10例,下颌升支矢状劈开截骨术8例,下颌全牙列根尖下截骨术1例,颏成形术5例。超声骨刀在切骨时选Ⅰ～Ⅲ级切骨模式,调节出水量,刀头选OT7或OT7A。骨断端行坚强内固定。结果：切割精度高,对周围软组织无损伤,术中出血少,骨断端无坏死,创口一期愈合。结论：与传统骨切割技术对比,超声骨切割技术弥补了其存在的缺点和不足。超声骨刀的技术优势为：1）能识别软硬组织,只切割硬组织,对软组织无损伤,提高了手术安全性;2）切割时产热少,再加上冷水喷雾降温,不会对骨组织产生不可逆性坏死;3）切割时无震动,刀柄握持力轻,可控性强,避免了误操作,提高了切割精度,切割线不受限制,创口清晰,切骨线规则平整。故超声骨切割技术在正颌外科中的应用具有一定实用价值。Objective： To investigate the safety and effectiveness of piezoelectric device in orthognathic surgery compared to conventional instruments. Methods： A total of 13 patients （ten female and three male; aged from 20- 65 years） were collected in this study. Three patients were maxillary retrognathism, two were mandibular prognathism and eight patients were both problems. They were treated with eleven LeFort I osteotomies, nine sagittal split ramus osteotomies of the mandible, five genioplasty and one anterior mandibular subapical osteotomy. All surgeries were performed with piezosurgery. The power level was selected from Ⅰ to Ⅲ. OT7 or OT7A insert was used and rigid fixation with minplates was applied in the surgeries. Results： Bone was cut precisely without damage to soft tissue and with little bleeding. No bone necrosis happened and the wound was healed well. Conclusion： Compared to the conventional bone cutting technique, the advantages of piezosurgery are： 1）only cutting hard tissue and minimizing the risk of harming adjacent soft tissue suggests that it is possible in orthognathic surgery at a high level of safety. 2）the temperature is low during the procedure with copious irrigation and without necrosis of the bone tissue. 3）it requirs lower hand pressure on the device.

关 键 词：超声骨切割技术 正颌外科 

分 类 号：R782.2[医药卫生—口腔医学]