半侧颜面短小畸形下颌骨牵张成骨方向的探讨  

Discussion on the vector of mandibular distraction osteogenesis for hemifacial mircrosomia

作　　者：唐晓军[1] 石蕾[1] 尹琳[1] 张智勇[1] 刘伟 尹宏宇[1] 杨亦楠[1] 王璇[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颌面整形外科中心,北京100144

出　　处：《中国美容整形外科杂志》2015年第7期394-397,共4页Chinese Journal of Aesthetic and Plastic Surgery

基　　金：北京市科委首都临床特色应用研究专项-基于数字化技术的儿童半侧小面畸形早期综合治疗效果评估基金资助项目（z121107001012112）

摘　　要：目的 通过数字化设计和模拟技术分析并探讨半侧颜面短小畸形下颌骨牵张成骨最有效的方向.方法 自2010-2014年,我们对60例半侧颜面短小患者进行下颌骨牵张成骨治疗,对安氏Ⅰ、Ⅱ类咬（牙合）畸形延长的方向分别是垂直于咬（牙合）平面和位于咬（牙合）平面和其垂线之间,通过数字化模拟来确定角度.结果 60例患者中,3例牵引器脱落,5例发生感染,其余患者均顺利完成延长成骨的治疗,患侧下颌骨高度得到良好的恢复;偏斜的咬（牙合）平面获得纠正,咬（牙合）关系恢复很好;颏部偏斜得到很大改善,面部对称性有明显的提高.结论 对于安氏Ⅰ类咬（牙合）最有效的延长方向是与颌平面垂直,对于安氏Ⅱ类咬（牙合）畸形最有效的延长方向是颌平面与其垂直线之间,需要术前数字化模拟来确定准确的角度.Objective To explore the most effective vector of mandibular distraction osteogenesis for hemifacial microsomia using the digital techniques. Methods From 2010 to 2014, 60 patients of hemifacial microsomia were performed the procedures of mandibular distraction osteogenesis using digital techniques. The vector perpendicular to the occlusal plane was applied for the patients with class I malocclusion. The vector should be situated between the occlusal plane and its vertical line for the patients with class Ⅱ, the angle should be determined using the digital techniques. Results The treatment on 60 cases were successful except for 3 cases with distractor displacement and 5 case with infection. The height of the mandibular ramus and the de- viation of the chin were improvement and the cant of occlusal plane was almost corrected. Conclusion The most effective distractive direction is perpendicular to the occlusal plane for patients with angle class I , while, to the patients with angle class Ⅱ, the vector should go between the occlusal plane and its perpendicular line, the precise angle should be made and simulated using the digital techniques.

关 键 词：半侧颜面短小 下颌骨 牵张成骨 数字化 

分 类 号：R782.2[医药卫生—口腔医学]