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作 者:李耀俊[1] 阮征[1] 张学斌[1] 忻文雷[1] 厉祯[1] 黄远亮[1]
机构地区:[1]同济大学附属东方医院口腔科,上海200120
出 处:《口腔颌面外科杂志》2013年第4期290-292,共3页Journal of Oral and Maxillofacial Surgery
摘 要:目的:探讨下颌骨髁突囊内骨折治疗的临床疗效。方法:24例28侧下颌骨髁突囊内骨折患者,分别进行保守治疗10例(后牙垫+前牙区颌间弹性牵引,或不处理骨折仅张口训练和观察)和手术治疗14例(髁突复位内固定+颌间牵引,下颌升支后缘离断髁突复位固定+颌间牵引),随访观察0.5~6年,对患者的自我感觉(疼痛)、开口度、咬合关系、下颌骨前伸和侧方运动、面神经功能及影像学检查等进行比较分析。结果:24例随访患者中,经过评估后保守治疗的10例各项观察指标恢复良好,手术组和非手术组各项观察指标对比,无统计学差异。结论:下颌骨髁突囊内骨折治疗前应进行综合评估,骨折移位不显著且无严重功能障碍的采用保守治疗效果较好,下颌升支后缘离断髁突复位固定的方法应慎用。Objective: To summarize the clinical experience and understanding of the management on intracapsular condyle fracture.Methods: Retrospective review of 24 patients(28 sides).10 cases were treated with non-surgical managements(cushion + intermaxillary traction / observation only).14 cases treated by surgical reduction(replacement and fixation mandibular condyle + intermaxillary traction / replantation of the condylar segment using the ramus osteotomy + intermaxillary traction) respectively.Assessment was based on clinical data of pre-and post-treatment panoramic radiographs,CT scan,three-dimensional CT reconstructions and clinical data(dental occlusion,maximum mouth opening,lateral excursion,protrusive movement,facial nerve function,pain),and follow-up period from 0.5 ~6 years.Results: Clinical data demonstrated no significant difference between surgical and non-surgical management patients.Conclusion: Comprehensive assessment of multiple treatment outcomes demonstrate that the non-surgical treatment is high on options of priority.A technique such as replantation of the condylar segment using the ramus osteotomy can be used cautiously.
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