下颌骨髁突重建术后骨吸收影响因素分析  

Factors influencing bone resorption after reconstruction of mandibular condyle

作　　者：徐涛 盛健峰[1] 唐平[1] 胡俊 冉萍 Xu Tao;Sheng Jianfeng;Tang Ping;Hu Jun;Ran Ping(Department of Maxillofacial Surgery,the Third Hospital of Mianyang,Mianyang,Sichuan,621000,China;Department of Stomatology,Sichuan Science City Hospital,Mianyang,Sichuan,621000,China)

机构地区：[1]绵阳市第三人民医院颌面外科,四川绵阳621000 [2]绵阳市科学城医院口腔科

出　　处：《西南国防医药》2020年第12期1076-1080,共5页Medical Journal of National Defending Forces in Southwest China

摘　　要：目的探究下颌骨髁突重建术后骨吸收的影响因素。方法回顾性分析2010年5月~2018年3月接受下颌骨髁突重建术的患者共98例,根据不同重建方法、不同骨折部位以及不同重建材料等统计骨吸收发生情况,以此分析该类患者术后骨吸收发生的影响因素。结果游离复位手术患者发生骨吸收10例(23.81%),解剖复位手术患者发生骨吸收2例(3.57%),差异具有统计学意义(P <0.05),其平均吸收率在不同时间段基本无差别。重建材料选择自体下颌骨组织患者发生骨吸收5例(6.67%)、异位骨组织发生骨吸收3例(6.45%)、异体组织发生4例(9.09%),差异不具有统计学意义(P> 0.05);以异体组织为重建材料骨吸收率明显较高,在出院后3个月、6个月、9个月以及12个月的复查结果中明显高于自体下颌骨组织和异位骨组织,而以自体下颌骨组织及异体骨组织为重建材料的骨吸收率相比无明显差异。髁突颈部骨折发生骨吸收2例(8.70%)、髁突基底部骨折发生骨吸收3例(6.45%)、髁突头部骨折发生7例(9.09%),差异不具有统计学意义(P> 0.05);髁突骨折发生在头部时骨吸收率明显更高,其次是基底部骨折,髁突骨折发生在颈部时骨吸收率相对最低。结论下颌骨髁突重建术后,骨吸收时有发生,手术类型、重建材料的选择以及骨折部位均是骨吸收发生的影响因素之一。Objectiv e To explore the factors influencing bone resorption after the reconstruction of the mandibular condyle.Methods A total of 98 patients who underwent the reconstruction of the mandibular condyle in our department from May 2010 to March 2018 were retrospectively analyzed. The incidence of bone resorption was summarized for patients using different reconstruction methods, with different fracture sites, and choosing different materials for reconstruction. Then the results were used to analyze the factors influencing the incidence of bone resorption of the patients after the operation. Results Bone resorption was observed in ten patients undergoing free reduction(23.81%) and two patients undergoing anatomical reduction(3.57%), showing a statistically significant difference(P < 0.05);there was merely no difference between these patients in the average resorption rate in different periods. Bone resorption was found in five patients who chose autologous mandibular bone tissue as the material for reconstruction(6.67%), three patients who chose ectopic bone tissue as the material for reconstruction(6.45%), and four patients who chose allograft tissue as the material for reconstruction(9.09%), the difference was not statistically significant(P > 0.05). The reexamination results at three, six, nine, and 12 months after the discharge showed that the bone resorption rate in the patients who chose allograft tissues as the material for reconstruction materials was remarkably higher than the patients who chose autologous mandibular bone tissues and the patients who chose ectopic bone tissues. There was no marked difference in bone resorption rate between the patients who chose autologous mandibular bone tissues and the patients who chose ectopic bone tissues. Bone resorption was visualized in two patients with condylar neck fractures(8.70%), three patients with condylar base fractures(6.45%), and seven patients with condylar head fractures(9.09%), indicating no statistically significant difference(P > 0.05). The bone res

关 键 词：下颌骨髁突 重建术 骨吸收 影响因素 

分 类 号：R782.2[医药卫生—口腔医学]