天然珊瑚充填治疗小颏畸形的远期随访观察  

LONG-TERM FOLLOW-UP OF MICROGENIA TREATMENT WITH NATURAL CORAL

作　　者：苏若为[1] 刘剑锋[1] 归来[1] 牛峰[1] 陈莹[1] 王梦[1] 

机构地区：[1]中国医学科学院北京协和医学院整形外科医院颅颌面外科,北京100144

出　　处：《中国修复重建外科杂志》2014年第11期1380-1384,共5页Chinese Journal of Reparative and Reconstructive Surgery

基　　金：卫生部部属(管)医院临床学科重点项目(2010-132)~~

摘　　要：目的 总结天然珊瑚充填治疗小颏畸形的远期疗效,探讨天然珊瑚与新生骨间的体积关系及新生骨的稳定性。方法 回顾分析1998年10月-2004年9月,采用颏部水平截骨结合天然珊瑚块充填治疗的12例小颏畸形患者临床资料。男7例,女5例;年龄15～28岁,平均18.5岁。术前、术后即刻及末次随访时对患者面容及头颅X线片进行测量,分析下唇点至颏下点垂直距离、颏前点至鼻根点和下牙槽点连线的距离、下牙槽点至颏下点的垂直距离、颏部截骨间隙垂直距离,并计算各指标复发率。结果 患者口内切口均Ⅰ期愈合,无手术并发症发生。患者均获随访,随访时间8～12年,平均9.2年。头颅X线片复查示,8年后珊瑚块蜂窝状结构均完全消失,被骨组织替代。术后8年后取出钛板时见颏部新生骨具有良好的强度和颏肌骨膜附着。末次随访时下唇点至颏下点垂直距离、下牙槽点至颏下点的垂直距离、颏部截骨间隙垂直距离均较术后即刻缩短,平均复发率分别为6.1%、22.9%、31.7%;而颏前点至鼻根点和下牙槽点连线的距离无明显变化。9例患者对手术疗效满意;3例再次调整颏部形态边缘。结论 天然珊瑚充填治疗小颏畸形后,尽管存在部分体积丢失,但能耐获得稳定的新骨和满意的远期疗效。Objective To investigate the long-term effectiveness of microgenia treatment with natural coral, and the volume relationship between the implant and the new bone. Methods A retrospective analysis was made on the clinical data of 12 patients with microgenia treated by horizontal genioplasty with natural coral implantation between October 1998 and September 2004. There were 7 males and 5 females with the average age of 18.5 years （range, 15-28 years）. The cephalometric data on the photo and X-ray films were collected at pre-operation, immediate after operation, and last follow-up. The vertical distance between lower lip point and inferior mental point, the vertical distance between inferior alveolar point and inferior mental point, the vertical distance of the osteotomic gap, and the distance between pogonion and the line between nasion and inferior alveolar point were measured, and the recurrence rates were caculated. Results All incisions healed by first intention, and no complication occurred. All patients were followed up 8-12 years （mean, 9.2 years）. X-ray films showed that the natural coral was replaced by new bone formation in the mental osteotomic gap; the new bone had good strength and firmly attached to the mentalis and periosteum. At last follow-up, the vertical distance between lower lip point and inferior mental point, the vertical distance between inferior alveolar point and inferior mental point, and the vertical distance of the osteotomic gap were decreased when compared with the ones at immediate after operation, and the mean recurrence rates were 6.1%, 22.9%, and 31.7%, respectively; and no obvious change was observed in the vertical distance between pogonion and the line between nasion and inferior alveolar point. Nine patients were satisfied with operation eff ectiveness; chin morphology was adjusted again in 3 patients. Conclusion Natural coral is a safe and effective bone substitute with enough stable new bone and good long-term effectiveness.

关 键 词：天然珊瑚 小颏畸形 新骨形成 远期疗效 

分 类 号：R782[医药卫生—口腔医学]