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??Objective    To explore the effect of chitosan antibacterial film spray on healing of intraoral incision. Methods    Totally 60 patients with small salivary gland mucocele were selected in this study?? and they were divided into A and B groups randomly?? each group with 30 cases. After operation?? group A was given Kangfuxin liquid for gargle?? and group B was given  not only Kangfuxin liquid but also chitosan antibacterial film spray. Compare the bacterial infections of incision?? the pain levels?? the time of incision healing?? the quality of incision healing and the incidence of adverse reaction between two groups. Results    After operation?? compared with  group A?? bacteria detected in group B declined?? what’s more?? patients’ feeling of pain was relieved?? the time of incision healing was reduced?? and the quality of incision healing was better. Both groups had no adverse reaction. Conclusion    The chitosan antibacterial film spray can shorten the healing time of intraoral incision and improve the quality of incision healing.     

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??Objective    To evaluate the advancement of zinc for bone repair with osteoporosis. Methods    The osteoporosis model have been established by ovariectomy??OVX??in female rats  for 12 weeks. Then??critical defects??5 mm??were prepared in bilateral mandible with a trephine and the rats were divided into three groups as the repair methods??in which experimental group were restored with zinc-releasing calcium phosphate ceramic/hydroxyapatite??Zn-TCP/HA????control group with β-TCP and blank control group were sutured directly. After 12 weeks??improved bone repair and shorten healing time in the OVX rats would be tested through biomechanical tests??radiographic and histological examination. Results    Osteoporosis in mandibular of female rats had been confirmed by bone density testified. Then??12 weeks after implantation??experimental group showed better bone repair than control group and blank control group through biomechanical tests??radiographic and histological examination. Conlusion    Zn-releassing scaffolds would obviously improved bone regeneration of the critical-sized defect in OVX rats model and provides valuable information for the therapy of osteoporosis related diseases by tissue engineering approach.     

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??Abstract??Objective To compare the clinical effect of different treatments for relaxation incision in palatoplasty??postoperative reaction and incision healing. Methods Totally 113 patients with cleft palate were divided into three groups randomly??who underwent palatoplasty. Iodoform gauze ??nothing or absorbable hemostatic gauze was used on both sides of the relaxation incision. After surgery??the diet??temperature changes??wound healing and bleeding??postoperative cleft or perforation were observed and analyzed. Results In Iodoform gauze group??2 cases of postoperative infection were found in all cases??12 patients had fever on the 3ird day??16 patients developed bleeding and one patient had postoperative cleft perforation. There were 4 and 5 patients with fever on the 3rd day of postoperation in the other two groups. Conclusion Nothing and filling into relaxation incision with absorbable hemostatic gauze are more helpful for wound healing and postoperative recovery in palatoplasty.     

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??Abstract??Objective To make doctor perform operation accurately on patients with dentomaxillofacial deformity by preoperative simulation based on digital data which was collected by digital software. Methods Fifteen patients had previously undergone 3-dimensional computed tomography and the data from CT scan were input into digital software. We used the software to simulate operations preoperatively including fixing point??osteotomies and movements of jaw bones. The collected information from software was applied to actual operations. Results All the operations had been completed successfully without serious complication. The patients were satisfied with the effect of operation 6 months after operation??with a satisfaction rate of 93.3%. Conclusion The digital simulation technique is a precise method which provides practical and effective basis for establishing the preoperative planning of individual optimal surgical procedure for patients with dentomaxillofacial deformities in orthognathic surgery.     

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??Objective    To explore the application of digital technology to the treatment of dento-maxillofacial deformities. Methods    Twelve patients with dento-maxillofacial deformities were enrolled and DICOM data were reconstructed with 3D-CT of maxillary and mandible. The DICOM data were input into the software of Proplan CMF. We built digital skull model and 3D-printed skull model to perform surgical planning?? postoperative prediction and simulate operation. Clinical examinations of facial symmetry were performed 3 months later. Results    All the surgical plannings?? postoperative predictions and simulate operations of the twelve patients with dento-maxillofacial deformities were performed. And the orthognathic surgery was successfully. The patients were satisfied with the facial symmetry 3 months after operations?? with a satisfaction rate of 91.67%?? Conclusion    When using digital technology to perform surgical planning and simulate operation??the accuracy of surgeries is improved with satisfactory effect. So the digital technology has practical value in the treatment of dento-maxillofacial deformities.     

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目的    探讨全面部骨折各种手术复位径路的可行性及优缺点。方法    对2002—2009年在宿州市立医院口腔颌面外科救治的资料完整的69例全面部骨折手术病例复位手术径路进行回顾性分析。结果    69例患者中,有47例采用了头皮冠状切口+小切口,22例单纯采取局部小切口。术后随访平均6个月,患者在功能上皆取得了良好的治疗效果,并发症表现各有不同。结论    冠状切口+小切口和单纯局部小切口在不同适应证中均可获得满意的治疗效果,应进一步研究如何减少冠状切口的并发症和如何应用微创切口对全面部骨折进行良好复位。     

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骨代谢过程中,锌是不可缺少的重要微量元素之一,适量的锌对成骨细胞增殖、分化、凋亡等生理过程有重要的作用。本文就锌对成骨细胞生物学作用方面的影响、作用机制及研究现状做一综述。     

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目的：评估排龈术对龈下楔状缺损修复效果的影响。方法选择2008年2月至2009年7月来南京大学医学院附属口腔医院牙体牙髓科就诊的双侧上颌前磨牙颈部楔状缺损患者40例,将同一患者的两侧患牙随机分为排龈组与对照组（各40颗牙）,排龈组在排龈线排龈后用Z350复合树脂充填,对照组直接用Z350复合树脂充填。随访2年,观察其临床疗效,评价修复体保存、边缘密合性以及继发龋发生情况。结果充填1周后首次复查,排龈组悬突发生率低于对照组,差异有统计学意义（P〈0.05）。充填1年和2年后复查,排龈组修复体的脱落率均明显低于对照组,差异有统计学意义（P〈0.05）。结论排龈术可提高龈下楔状缺损修复的治疗效果。     

内镜辅助下颧弓骨折切开复位内固定治疗的临床研究

目的探讨内镜辅助下行颧弓骨折复位内固定的相关技术及临床价值。方法选择18例患者,其中单侧颧弓骨折10例,单侧颧骨颧弓骨折8例,均在内镜辅助下经面部小切口暴露颧弓骨折断端,行断端解剖复位后,采用钛板在内镜辅助下进行颧弓骨折坚固内固定,恢复颧弓解剖形态。结果所有病例术后双侧颧部对称,无张口、咀嚼功能障碍及明显并发症发生。面部瘢痕隐蔽,无明显瘢痕畸形。术后CT检查显示颧弓颧骨基本解剖复位,钛板固定位置良好。结论 内镜辅助下经面部小切口行颧弓骨折复位内固定治疗,手术创伤小,骨折复位效果好,并发症少,可作为部分颧弓骨折病例治疗的选择术式。     

Modification of surgical technique in isolated zygomatic arch fracture repair: seven case studies

Closed reduction is applied in most cases of isolated zygomatic arch fracture. Open reduction and internal rigid fixation through a coronal incision have to be performed in other comminuted arch fractures. The authors introduced an endoscopic-assisted approach via a small preauricular incision to achieve reposition and osteosynthesis of isolated zygomatic arch fractures. The endoscopic-assisted surgical technique was performed in 7 patients with unilateral isolated zygomatic arch fractures. Endoscopically controlled management of the isolated zygomatic arch fracture was feasible in all 7 patients. The follow-up period was 1 year. All preauricular scar and facial lateral contour were aesthetically satisfactory. The endoscope-assisted approach via a small preauricular incision can achieve in situ reduction and fixation in zygomatic arch fracture and it should become an integral part of isolated zygomatic fracture repair, assuming the development of specialized training programs and improvements in endoscopes.     

自制单齿钩治疗单纯颧弓“M”型骨折的临床观察

[摘要] 目的 探讨自制单齿钩复位单纯颧弓"M"型骨折的临床疗效。方法 对36例患者应用自制单齿钩经皮穿刺复位,术后影像学随访。结果 36例患者均治愈,面部外形满意,无张口受限,面部无明显瘢痕及神经损伤等症状。结论 该方法复位创伤小,并能有效恢复颧弓外形及开口功能,临床疗效佳。     

抓钩式内支撑颧弓骨折固定器的研制及生物力学稳定性的研究

目的 研制一种基于口内入路的抓钩式内支撑颧弓骨折固定器并比较此固定器与其它固定的力学稳定性。方法 将20侧颧弓制备成二线型骨折,按实验的先后顺序分成4组:只复位而不予固定(对照组);微钛板微钛钉固定(微钛板组);抓钩式内支撑颧弓骨折固定器固定,抓钩末端达颧弓中轴线(抓钩1组),抓钩末端未达颧弓中轴线(抓钩2组)。对4组颧弓进行垂直加载试验,记录各组的最大载荷和抓钩1组、抓钩2组和微钛板组载荷-位移曲线中0.5 mm、1.0 mm、1.5 mm和2.0mm位移所对应的载荷。结果 对照组的最大载荷小于抓钩1组和抓钩2组;微钛板组的最大载荷大于抓钩1组和抓钩2组;抓钩1组和抓钩2组的最大载荷差异无显著性。0.5 mm、1.0 mm、1.5 mm和2.0 mm位移所对应的载荷,微钛板组大于抓钩1组、抓钩2组;抓钩1组和抓钩2组差异无显著性。结论 抓钩式内支撑颧弓骨折固定器使用方便、固定牢靠,能有效防止外在压力对已复位骨折造成再移位。     

C臂机数字减影下微型钛螺纹钉外固定器治疗颧弓骨折的临床研究

目的：探讨钛螺纹钉外固定器治疗颧弓骨折的临床效果。方法：26例颧弓骨折病例在C臂数字减影机引导下,将钛螺纹钉拧入骨折断端骨质中,通过调整外固定器使骨折段精确复位并固定。结果：26例颧弓骨折术后复位精确,固位稳定,愈合好,无感染,皮肤无疤痕,面形恢复正常。结论：钛螺纹钉外固定器治疗颧弓骨折具有创伤小、方法简单、复位准确的特点,是一种治疗颧弓骨折较为理想的方法。     

耳颞切口联合可吸收接骨板治疗颧弓粉碎性骨折——附8例报告

目的：评价耳颞切口联合可吸收板治疗颧弓粉碎性骨折的疗效。方法：采用耳颞切口,显露复位颧弓骨折段后应用可吸收接骨板对8例单纯颧弓粉碎性骨折病例进行坚强内固定,通过面形、张口度、伤口愈合情况及X线片评价手术效果。结果：8例患者除1例术后有轻度张口受限,1例出现暂时性面瘫外,其余均开口度正常,面形对称,切口甲级愈合,手术效果良好。结论：以耳颞切口入路,可吸收接骨板行颧弓骨折坚强内固定,操作简便,损伤小,并发症少,效果良好,是一种较好的颧弓粉碎性骨折治疗方法。     

外科导航技术在颧骨颧弓骨折治疗中的应用

颧骨颧弓骨折是最常见的面中部骨折之一,颧骨颧弓骨折常引起患者张口、咀嚼等功能障碍,多伴有明显的颧面部畸形,进而造成患者心理和生理的双重问题。对其治疗也因为该部位解剖结构的复杂性而存在着不少困难。外科导航技术的出现为颧骨颧弓骨折提供了一种新的辅助治疗方法。本文就外科导航技术在颧骨颧弓骨折方面的应用作一综述。     

颧弓解剖测量及其应用解剖

目的测量成年人的颧弓解剖参数,为研制一种新型的颧弓骨折固定器提供解剖依据。方法用游标卡尺测量107个干颅骨标本(男56个,女51个)的颧弓。测量内容包括颧弓上下缘弦长、颧弓深度、颧弓厚度、颧弓宽度和颧弓下缘厚度。结果男性、女性颧弓相关测量的各项结果左右比较,男性、女性颧弓左右差异无显著性。男女性颧弓相关测量的各项结果男女比较,有显著性差异。男性颧弓的上下缘弦长、宽度、深度、厚度和下缘厚度均大于女性颧弓。结论颧弓下缘处不宜行钛板钛钉坚强内固定,坚强内固定的位置应是颧弓外表面中轴线上。     

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提要：颧骨复合体骨折（zygomatic complex fractures,ZCF）是颌面部常见的骨折之一,近年来发病率呈上升趋势。目前,颧骨复合体骨折的治疗包括保守治疗和手术治疗两类。随着“功能与外形双项标准” 的提出,颧骨复合体骨折的开放治疗逐渐增多。本文介绍了颧骨复合体骨折治疗的现状以及存在的问题,并对颧骨复合体骨折的规范治疗做一简述。     

Mimics软件在颧骨复合体骨折三维CT图像中的测量与应用

目的探讨单侧颧骨复合体骨折移位的CT测量方法并用于指导临床手术。方法收集需要手术治疗的单侧颧骨复合体骨折患者20例,术前摄颌面部三维CT,利用Mimics软件对双侧颧骨复合体与邻近骨骼解剖标志点中选取的同样两点之间的距离和选取同样的三点之间的角度进行测量分析,计算患侧与健侧之间的差值,以此为骨折移位数据指导手术。术后复查CT并测量各段距离和角度,评价复位效果。结果1）颧骨复合体骨折时,颧骨体骨折块多向后、向内移位。术后患侧与健侧比较,骨折段移位距离差值减少至2 mm以内,角度差值减少至1°以内,复位达到三维对称,开口及咬合功能恢复好,手术效果满意。2）健侧的颧弓突点水平角和颧突点水平角数据呈正态分布,分别为138.50°±1.15°和132.72°±0.89°。结论三维CT测量可以实现对颧骨复合体空间移位的定量测量,对颧骨复合体骨折的手术复位具有指导意义。