摘要
目的探讨小型钛板坚强内固定辅以颌间固定在下颌角不利型骨折治疗中的疗效。方法选取111例下颌角不利型骨折患者,分为钛板单用组38例、牙弓夹板联用组36例、自攻钛钉联用组37例。钛板单用组采用小型钛板坚强内固定治疗,牙弓夹板组和自攻钛钉组分别在小型钛板坚强内固定的基础上辅以牙弓夹板和钛钉颌间牵引治疗,全部患者随访半年,比较3种治疗方法的疗效和不良反应发生情况。结果钛板单用组、牙弓夹板联用组、自攻钛钉联用组的有效率分别为76.32%、86.11%、91.89%,牙弓夹板联用组和自攻钛钉联用组的疗效均优于钛板单用组,差异有统计学意义(P<0.05),其中以自攻钛钉联用组的疗效最佳。3组术后感染和张口受限出现率差异均无统计学意义(P>0.05);牙弓夹板联用组、自攻钛钉联用组牙齿疼痛、咬合紊乱和面部畸形的发生率均低于钛板单用组,差异有统计学意义(P<0.05)。自攻钛钉联用组术后不良反应的发生率最低。结论在下颌角不利型骨折的治疗中应用小型钛板坚强内固定辅以颌间固定有利于骨折愈合和咬合关系、面部外形的恢复,其中辅以自攻钛钉颌间牵引的效果较辅以牙弓夹板固定效果更好。
Objective To explore the clinical application of small titanium plate internal fixation combined with inter- maxillary traction in the treatment of mandibular fractures. Methods One hundred anti eleven patients with mandibular unfavorable fractures were selected and divided into titanium plate single group （38 cases） , splint combination group （36 cases） and titanium screw combination group （37 cases）. Titanium plate single group used onlv a single small titanium plate. Splint comhination group used miniature titanium plate with dental arch splint anti Titanium screw combination group used miniature titanium plate with titanium screw. All patients followed up for at least half a year, comparing the efficacy and adverse l^actions. Results The effective rates of titanium plate single group, splint combination group and titanium screw combination group are 76.32% , 86.11% , 91.89% , efficacy of splint combination group and titanium screw combination group were superior than titanium plate single group, it was statistically significant difference （ P 〈 0.05）, in which titanium screw combination group got the best effect. The post-operation infection and mouth opening limitation rate among 3 groups had no statistical difference （ P 〉 0.05 ）, the teeth pain, occlusal disorders and facial mal- formations of splint combination group and titanium screw combination group were lower than titanium plate single group. the difference was statistically significant （P 〈 0.05 ）. Combined with the post-operation incidence of adverse reaction of titanium screw combination group was lowest. Conclusion In the treatment of mandibular fractures, the application of mini titanium plate internal fixation combined with intermaxillary traction takes advantage of fracture healing, occluding relation anti facial appearance recovery. The effect of mini titanium plate internal fixation combined with titanium screw intermaxillary tractiun compared splint is more ideal.
出处
《广东牙病防治》
2014年第9期467-470,共4页
Journal of Dental Prevention and Treatment
关键词
小型钛板
牙弓夹板
钛钉
内固定
颌间牵引
下颌骨骨折
Small titanium plate
Dental arch splint
Titanium screw
Internal fixation
Intermaxillary trac-tion
Mandibular t^acture
