牵张成骨和正颌外科治疗火器伤性颌面部缺损和畸形  

Treatment of dento-maxillofacial deformities wounded by firearm by distraction osteogenesis and orthognathic Surgery

作　　者：陈书军[1] 牛学刚[1] 韩小宪[1] 陈宇轩[1] 李正勇[1] 

机构地区：[1]解放军第二五二医院口腔科,主治医师河北071000

出　　处：《口腔颌面修复学杂志》2011年第1期49-52,共4页Chinese Journal of Prosthodontics

摘　　要：目的:探讨牵张成骨和正颌外科技术治疗火器伤性牙颌面畸形的临床应用。方法:1例患者因火器伤严重颌面部畸形,主要表现为右侧升支高度严重不足、咬合关系错乱和上颌牙弓缩窄。手术采用牵张成骨技术,分两次牵张,恢复右侧升支高度。继而采用正颌外科方法矫正咬合关系。结果:患者均顺利完成治疗,一期牵张成骨骨延长约10mm,二期延长约15mm,右侧下颌升支高度基本恢复,正颌外科术后,患者面型得到明显改善,咬合关系恢复,对治疗效果满意。结论:颌面部火器伤会导致严重的软组织瘢痕,骨再生能力降低,造成的畸形复杂,不规则。在应用牵张成骨和正颌外科治疗火器伤性牙颌面畸形必须要遵从其基本原理,同时要兼顾火器伤牙颌面畸形的临床特点,进行个性化设计,最终可以得到良好的治疗效果。Objective： To study the clinical treatment of dento-maxillofacial deformities wounded by firearm by distraction osteogenesis and orthognathic surgery.Methods： Dento-maxillofacial deformities in one patients wounded by firearm were operated,characterized by deficiency in the height of ramus,malocclusion and changes in maxillary arch width.Distraction osteogeneses,divided into two times,were firstly carried out for the restoration of ramus height,followed by an orthognathic operation for occlusal reconstruction.Results： All the operations were performed as planned.The bone transport disk was distracted about 10mm in the first distraction,and about 15mm in the second.The right ramus got a similar height compared with the left.After the orthognathic operation,occlusion was reconstructed.The patient was significantly improved in the appearance,and satisfactory with the results.Conclusion： Dento-maxillofacial deformities wounded by firearm were characterized by serious scar tissues,decreased ability of bone regeneration and complication in deformities.Therefore,individual protocol should be taken into consideration when treated with distraction osteogenesis and orthognathic surgery,provided that the basic principles were followed.It suggested that satisfactory results should be gained when a reasonable design was done.

关 键 词：牵张成骨 正颌外科 火器伤 牙颌面畸形 

分 类 号：R783[医药卫生—口腔医学]