颌间牵引钉在颌骨骨折内固定手术治疗中的临床应用研究  

Clinical study on intermaxillary traction screws used in internal fixation in the treatment of jaw fracture

作　　者：白振西[1] 高志彪[1] 肖霞[1] 张文娟[1] 樊星[1] 

机构地区：[1]延安大学附属医院口腔科,716000

出　　处：《实用口腔医学杂志》2015年第2期219-224,共6页Journal of Practical Stomatology

摘　　要：目的：总结分析颌间牵引钉在颌骨骨折手术治疗中的使用方法、效果及注意事项。方法：在168例颌骨骨折内固定手术中,应用颌间牵引钉牵引骨折端复位,恢复并维持咬合关系稳定。记录颌间牵引钉使用数目、位置、牵引效果及术后并发症。结果：168例手术中共使用颌间牵引钉705枚,其中：使用4枚者147例（88%）,6枚者12例（7%）,5枚者9例（5%）。使用位置：5-4 4-55-4 4-5牙根间336枚（47.7%）,4-3 3-44-3 3-4牙根间292枚（41.4%）,6-5 5-66-5 5-6牙根间50枚（7.1%）;其余部位27枚（3.8%）。术后92例咬合关系正常,无需牵引;76例咬合关系不协调或有偏差,经术后4~14 d牵引,71例咬合关系恢复正常,总有效率97%。主要并发症是牵引钉周围黏膜疼痛23例（13.7%）,牙根损伤13例（1.8%）、牵引钉松动11例（1.6%）、牙脱位2例（0.3%）。结论：颌间牵引钉最常见和安全的植入位置在尖牙到第一磨牙的牙根之间,植入位点距牙龈缘5~8 mm;植入数目4~6枚可满足手术需要;颌间牵引钉弹性牵引有一定并发症,应注意防范。Objective：To analyse the methord and effects of intermaxillary traction（IMT）screws used in the treatment of jaw frac-ture.Methods：In the treatment of 1 68 cases of jaw fracture IMT screws were used for the restoration of normal and stable occlusion. The screw number,position,traction effect and postoperative complications of the treatment were analysed.Results：705 screws were used in 168 patients,4 screws were used in each of 147 cased （88%）,6 in 12（7%）,5 in 9（5%）.336（47.7%）screws were fixed between the roots of first and second premolar,292（41 .4%）between the roots of canine and first premolar,50 （7.1%）be-tween the roots of second premolar and first molar,27（3.8%）between the other tooth roots.Normal postoperative occlusion relation was achived by the use of screws in 92 cases without traction.Occlusion disharmony or deviation was found in 76 cases by the used of screws and was restored to normlal by 1 4-day traction in 71 cases.The total efficiency of the treatment was 97%.Pain of the mucosa surrounding the screws was observed in 23 cases （1 3.7%）.Root damage,traction screw loosening and adjacent tooth dislocation were observed in 1 3（1 .8%）,1 1 （1 .6%）and 2（0.3%）cases respectively.Conclusion：For the fixation of IMT screws,the posi-tions between tooth root from canine to first molar were most common and safe.The fixation point should be in 5 ~8mm below the gin-gival margin.Use of 4-6 screws can meet treatment need.

关 键 词：颌间牵引钉(IMT) 颌骨骨折 内固定 手术 

分 类 号：R782.4[医药卫生—口腔医学]