单侧下颌骨缺损重建术后下颌骨形态及髁突位置的三维定量分析

目的：分析单侧下颌骨缺损重建术后下颌骨形态及髁突位置变化，为下一步建立下颌骨定量分析方法提供参考。方法：下颌骨缺损腓骨重建患者术前及术后均行锥形束CT检查，上颌骨定点匹配重叠后定量分析术前与术后下颌骨形态、髁突位置的变化。结果：单侧下颌骨缺损重建术后健侧下颌骨形态及髁突位置变化无统计学意义（P > 0.05）；对于骨缺损不累及髁突的患者，重建术后患侧下颌骨形态及髁突位置变化无统计学意义（P > 0.05）；对于骨缺损累及髁突的患者，重建术后患侧下颌骨的形态变化无统计学意义（P > 0.05），而髁突位置表现为向外向下移位，差异具有统计学意义（P < 0.05）。结论：单侧下颌骨缺损腓骨重建术可以健侧下颌骨作为匹配区域分析患侧下颌骨形态及位置变化。本研究结果可为建立下颌骨定量分析方法提供参考和依据。

Three-dimensional Analysis of Mandibular Morphology and Condylar Position after Reconstruction of Unilateral Mandibular Defect

Mandibular defect can seriously affect patient''s appearance, temporomandibular joint and dental function. OBJECTIVE: To provide reference for the establishment of a precise analysis method for mandibular reconstruction. METHODS: 23 patients with mandibular defect reconstructed by fibula were studied by CT before and after operation. The position changes of mandible before and after operation were measured. RESULTS: There was no significant change in the shape and position of the contralateral mandible after reconstruction of mandibular defect(P>0.05). There was no difference in the shape and position of the affected mandible in the patients who retained the condyle after reconstruction(P>0.05). There was no significant diversity in the shape of the affected mandible in the patients who remove the condyle(P>0.05), but the position of condyle was shifted outward and downward, with significant difference (P < 0.05). CONCLUSION: The shape and condylar position of the contralateral mandible remained unchanged after fibular reconstruction of unilateral mandibular defect. The position of condyle involved in mandibular reconstruction of condylar process was changed, mainly in the form of outward and downward displacement.