颌间固位钉和牙弓夹板在颌骨骨折治疗中的临床应用

目的比较颌间固位钉和牙弓夹板两种牵引方法在颌骨骨折牵引固定中的临床疗效。方法把48例有咬合紊乱症状的颌骨骨折患者随机分成2组,每组24人,研究组用颌间固位钉植入上下颌骨,对照组用牙弓夹板结扎固定在上下牙列上,2组均采用弹力皮圈在术中牵引辅助复位或在术后牵引调整咬合关系,所有患者均接受了骨折切开复位及小型钛板＋螺纹钉固定骨折。检查并记录2组的平均操作时间,术后咬合关系的恢复程度,牙周损害程度,口腔卫生状况,询问患者主观感受,给予统计学分析,得出结论并进行临床疗效判定。结果研究组平均操作时间明显短于对照组;研究组患者的牙周损害程度明显轻于对照组;研究组患者的口腔卫生状况也明显好于对照组;颌间固位钉牵引复位大大减少了患者的副损害和痛苦;从主观舒适度方面,患者更能接受颌间固位钉牵引复位法;在牙列基本完整的前提下,两者在咬合关系的恢复方面无明显差异。结论颌间固位钉较牙弓夹板牵引复位或辅助治疗颌骨骨折是一种快速、简单且有效的方法,值得临床推广使用。

A clinical utilization of intermaxillary fixation screws and arch bars in treatment of mandibular fracture

Objective To compare the clinical curative effect of intermaxillary fixation screws and arch bars the traction and fixation of mandibular fracture. Methods Forty-eight cases of mandibular fracture patients with the occlusion disorder were random divided into two groups with twenty-four patients in each group; the research group underwent intermaxillary fixation and traction with the intermaxillary fixation screws implanted in bone,while the control group underwent arch bars fixed on the teeth. We use elastic apron to intermaxillary traction for auxiliary reset during the intraoperative or occlusal adjustment after surgery,all patients underwent fractures dissection restoration and small titanium plate ＋ screw nails fixed fractures. The operation time,recovery degree of occlusal,periodontal damage situation and oral hygiene of the two groups were recorded. The subjective feeling of all patients was surveyed,and statistical analysis was used to evaluate the clinical effect. Results The average operation time of the research group was short than that in the control group,and the degree of periodontal lesions was slight in the research group and oral hygiene is significantly superior to the control group. The intermaxillary fixation greatly reduced the side damage and pain of the patients. From the subjective comfort of postoperative,the patients were more willing to accept the intermaxillary fixation screws. On the premise of basic intact of dental arch,the recovery degree of occlusal has no obvious difference between the two groups. Conclusion As compared to arch bars,intermaxillary fixation screws for intermaxillary traction and fixation therapy or auxiliary treatment of mandibular fracture is a fast,simple and effective method. It is deserved to promote clinical application.