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作 者:乔峰[1]
出 处:《天津医药》2011年第11期1025-1027,共3页Tianjin Medical Journal
摘 要:目的:探讨上颌骨陈旧性骨折牙颌畸形患者实施LeFortⅠ型截骨术及坚固内固定(RIF)矫治方法的临床效果。方法:选择2007年6月-2010年10月天津医科大学口腔医院外科收治的上颌骨陈旧性骨折错位愈合而致错畸形患者27例,经术前术后软硬组织X线头影测量分析、术前手术模拟预测(STO)分析、模型外科分析后,采用Le FortⅠ型截骨术及RIF手术治疗。对测量结果进行术前术后对比分析。结果:27例患者均获得满意的咬合功能和颜面形态。硬组织指标上颌突度、上颌突距[N-A(//HP)]和上前牙槽高[U1-PP(⊥PP)]在手术后较手术前减小,而上面高(N-ANS)则较术前增加(P<0.05或P<0.01)。软组织指标面中份突度[G-Sn(//HP)]和上唇至审美平面距[Ls-EP(⊥EP)]较术前减小,而鼻唇角(Cm-Sn-Ls)和上面高[G-Sn(⊥HP)]较术前增加(P<0.05或P<0.01)。术后随访3~6个月无复发。结论:LeFortⅠ型截骨术+RIF矫治上颌骨陈旧性骨折所致颜面畸形和咬合功能障碍可取得满意效果。Objective:To study the possibility of Le FortⅠosteotomy correction and rigid internal fixation (RIF) for old maxillary fracture and to evaluate the clinical efficacy.Methods:Twenty-seven patients with old maxilla fracture were treated by Le Fort I osteotomy based on pre-and postoperative cephalometric and preoperative simulation and prediction (STO)analysis with RIF.Model surgery was performed on dental casts preoperatively.The pre-and postoperative measurements were compared with each other.Results:All cases healed well and had satisfactory occlusal function and facial form.The values of maxillary protrusion (SNA),upper jaw protrusion distance[N-A(//HP)] and the cutting edge of central incisor to the palatal plane points[U1-PP(⊥PP)] were decreased after operation than those of before operation (P 0.05),but the value of N-ANS was increased(P 0.05).The values of G-Sn (//HP) and Ls-EP(⊥EP) were significantly decreased(P 0.05) after operation than those of before operation,but Cm-Sn-Ls and G-Sn(⊥HP) were increased compared with those of before operation (P 0.05).There was no recurrence after 3-6 months follow-up.Conclusion:Reconstruction of the maxillary with Le FortⅠ osteotomy and RIF is an effective method to treat delayed panfacial fractures.
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