摘要
目的通过对10年来我院经治患者随访调查,评价下颌骨缺损重建中不同材料、方法和不同缺损部位对术后疗效的影响。方法对华西医科大学口腔医院近10年下颌骨缺损患者378例进行随访。结果回访304例(80.4%),男170例、女134例,年龄3～77岁。下颌缺损修复应用植入材料的共192例,其中生物材料139例,非生物材料53例。180例可进行HCL分类,H类缺损包括关节头,共152例;L类缺损不包括关节头,共28例。植入材料对面部外形的恢复明显优于未植入组(P<0.01)生物材料组明显优于非生物材料组(P<0.01)。术后张口度的恢复,植入生物材料组明显优于非生物材料组(P<0.01)。C类比H类更易保持下颌中点居中的位置,张口度及侧向运动更好。结论下颌骨缺损应该尽可能予以即时一期修复,提倡应用生物材料,以自体骨组织移植为首选。应加强对非生物材料的基础研究,期望有更优良的非生物材料问世。如何重建包括髁突在内的下颌骨缺损仍是一个亟待解决的课题。
Objectives: To evaluate the effects of the factors, such as implant materials,location of the mandibular defects on the therapeutic effectiveness in mandibular restoration surgery by a 10_year_long folow_up.Methods:378 patients with mandibular defects in our hospital were followed up in the past ten years. 304 int_patients responded,(follow_up rate 80.4%). 170 were males and 134 females, aged 3 ～ 77 years old. Implant materials were used in 192 cases, out of which 139 were treated with biological materials and 53 were nonbiological materials.HCL classification could be used in 180 cases. Class H and class L were for 152 and 28 cases respectively. The cosmatic effects on facies of the group used implant materials were obviously better than those of the group without implant materials (P< 0.01). And the effects of biological materials group were superior to those of nonbiological group (P<0.01).The effects of biological materials on mouth_open recoverywere better than those of nonbiological matererials.The mandible midpoint of the class C was more easily maintained than those of class H ,the mouth_open and lateral movement were also better. Conclusions: The mandibular defects should be repaired at the same time of first operation. Biological materials are advocated and autogenous bony grafts are the first choice. Basic study for developing better nonbiological materials should be further strengthened. Reconstruction of the condyle and the temporomandibular joint is still a challenge and needs further studying.
出处
《中国口腔种植学杂志》
1999年第4期177-182,共6页
Chinese Journal of Oral Implantology
关键词
下颌骨缺损
生物材料
非生物材料
mandibular defects
reconstruction
biological materials
nonbiological materials
