颌骨骨折螺旋CT三维成像的诊断价值

目的：探讨螺旋CT三维成像对颌骨骨折的诊断价值。方法：采用TOSHIBA XPRESS／SX型螺旋CT对53例颌面部外3伤骨折行螺旋扫描，并进行三维骨表面重建，重建厚度为3mm，结果：二维CT和三维CT对颌骨骨折部位的显示无明显差异，但三维CT对骨折全貌，骨折断端及其移位程度的显示明显优于二维CT，结论：螺旋CT三维成像立体，直观，能完整地显示骨折全貌，对颌骨骨折的诊断和手术方案的制定具有重要意义。     

三维CT在颌面骨折中的应用

目的　了解三维CT在颌面部骨折中的诊断和治疗中的应用价值。方法　通过我院 15例颌面部骨折病例的三维CT扫描重建成像分析 ,与手术所见进行对比。结果　三维CT能清楚显示颌面部骨折的立体解剖图像 ,其显示的骨折程度、范围、移位方向与手术所见一致。结论　三维CT是颌面部骨折治疗中有效、直观的辅助检查方法。     

螺旋CT三维重建在髁突骨折中的临床运用

目的：评价螺旋CT三维重建技术在髁突骨折诊断及治疗中的应用．方法：对11例踝突骨折患者进行CT三维重建检查．通过三维CT影像对髁突骨折做出正确的诊断及指导临床手术的实施。结果：螺旋CT三维影像能立体、精确．多方位地显不骨折的部位、范围、移位及旋转等情况。结论：三维CT对髁突骨折后检查具有独特的诊断价值．同时对手术方案的制定具有指导意义,并能够优化手术方案。     

螺旋CT三维重建在颌骨骨折诊治的应用价值

目的探讨螺旋CT三维重建在临床治疗颌骨骨折的应用价值。方法收集16例颌骨骨折患者，对颌骨怀疑病变部位采用螺旋CT薄层扫描后并进行图像的三维重建，通过旋转三维图像，以不同角度观察颌骨骨折的立体征象，并用以指导手术。结果通过三维重建技术，16例患者骨折的部位，骨折线走向及骨折片移位情况，均获得了清楚的显示，为外科医师的诊断及手术设计提供了依据。结论螺旋CT三维重建技术在颌骨骨折的临床诊断及治疗中具有一定的指导意义。     

螺旋CT三维重建在髁突骨折治疗中的应用

目的 :探讨螺旋CT三维重建在髁突骨折治疗中的临床应用价值。方法 :对 14例 19侧髁突骨折病例运用螺旋CT扫描及三维重建 ,分析其图像并与X线平片对照。结果 :螺旋CT三维重建可直观地再现髁突骨折的全貌 ,清楚显示髁突骨折部位与移位的方向和程度。结论 :螺旋CT三维重建使临床医生更易理解髁突骨折的病理解剖关系 ,为制定和实施治疗计划提供有价值的信息。     

螺旋CT三维重建在髁突骨折中的应用

目的探讨螺旋CT三维重建在髁突骨折治疗中的应用价值。方法对47例56侧下颌骨髁突骨折患者的X线全景片和螺旋CT三维重建进行比较分析。结果对髁突骨折手术适应证判断,X线全景片和螺旋CT三维重建组间差异有统计学意义(P<0.05)。结论螺旋CT三维重建有利于确定髁突骨折情况以及骨折的移位程度,有利于治疗方案的设计与实施。     

口腔颌面部创伤

螺旋CT三维重建在髁突骨折中的临床运用；武警部队官兵颌面部骨折临床病例回顾性研究；钛网在颌骨粉碎性骨折复位中的应用；儿童颌面部骨折治疗的临床研究；颌面部创伤不同缝合法的心理学差异（附80例报告）；颌面部损伤患者265例的临床护理体会；颧上颌骨骨折42例临床分析；……[编者按]     

三维CT在颌面骨折中的应用

目的：评价三维CT影像技术在颌面骨折诊断及治疗中的应用。方法：对18例颌面骨折患者进行三维CT和二维CT检查，通过外科手术验证三维CT诊断的准确性。结果：三维CT成像能立体、精确、多方位地显示骨折部位、范围、移位、旋转、骨缺损范围等情况。结论：三维CT对颌面部骨折后畸形的检查具有独特的诊断价值，同时对手术方案的制定具有指导意义，并能够细化手术方案。     

影像技术在颌面部病变诊治中的对比分析

目的探讨X线片、螺旋CT二维成像、三维重建在颌面部病变诊治中的临床价值。方法 112例颌面部病变患者均行X线片检查,螺旋CT二维成像、三维重建,与术中所见对照分析。结果螺旋CT三维重建对上下颌骨骨折、颧骨复合体骨折、鼻眶筛骨折能直观地指导临床术前手术方案的制订,优于二维CT和X线片。对颌骨深部结构骨折不如二维CT。X线片对牙齿折断、牙根周围膜损伤效果最佳。二维CT在颌面部肿瘤区分其囊性或实性及周围组织的显示上,优于三维CT,在病变的形态学改变和临近结构的空间关系上三维CT优于二维CT。三维CT对于颌面骨发育畸形的显示,明显优于二维CT。结论在诊断颌面部病变中,X线片、螺旋CT二维成像、三维重建联合应用各取所长,最具有临床价值。     

螺旋二维及三维CT对颌面骨折的影像学研究

目的探讨螺旋二维CT、三维cT对颌面骨折的临床应用价值。方法对185例颌面骨折患者螺旋CT扫描，应用表面遮盖技术（shaded surface display，SSD）、多层面重建（multiplanar reformation，MPR）、应用Syngo软件勾画删除技术对图像进行分割，比较二维、三维CT诊断准确率。结果三维CT能清楚显示复杂颌面骨折的立体解剖图像与结构关系，并同时获得患者软组织实时图像，二维CT更好的提供细微骨折及深部骨折的信息，二者互补。扫描层厚越薄重建图像越清晰。结论三维CT有利于确定颌面骨折的程度与骨折的移位真实情况，对颌面部骨折的术前诊断和手术计划制定具有较大临床意义，是显示颌骨骨折的影像新技术。     

275例下颌骨骨折临床治疗体会

目的 探讨下颌骨骨折的治疗方法。方法 对铜川市人民医院口腔科1990-2002年收治的275例下颌骨骨折患者的临床资料进行分析。结果 ①非手术治疗的27例患者在颌间结扎过程中对全身情况影响较大,其中3例遗留面颌畸形;②手术治疗的248例病例中,钢丝内固定的73例患者术后有5例出现咬合关系紊乱,小型钛板坚固内固定的169例患者有6例术后二期手术取出钛板,可吸收夹板内固定的6例患者术后均取得了满意效果。结论 坚固内固定是目前治疗下颌骨骨折的一种较好的内固定方法。     

眶-上颌-颧骨复合骨折临床分类治疗探讨

目的:探讨眶-上颌-颧骨(OMZ)复合骨折三维立体结构上的分类法,以提高临床治疗水平。方法:收集69例OMZ骨折病例,通过常规X线片、螺旋CT片检查,从三维立体结构角度将骨折分为四型,总结临床治疗方法及效果。结果:术后随访2个月～4年,69例患者颧面部塌陷畸形均得到良好改善,咬合关系紊乱的患者均达到功能性咬合,通过训练后,张口度恢复满意,无面神经永久性损伤。A型骨折12例,无不良症状发生。B型骨折15例,有1例术后颧-眶外壁处仍稍显膨隆。C型骨折32例,有3例术后眶下神经麻痹症状未能恢复。D型骨折10例,术后眼球内陷1例,仍>2mm,复视未能恢复1例,眶下神经麻痹症状未恢复3例,术后切口感染1例,术后颧骨颧弓仍稍显膨隆3例。结论:眶-上颌-颧骨复合骨折四型分类法,对指导临床治疗有一定参考价值。     

Immediate and late mandibular fractures after third molar removal.

PURPOSE: In this retrospective study, we analyzed immediate and late mandibular fractures after impacted lower third molar surgery. PATIENTS AND METHODS: One hundred fifty oral and maxillofacial surgeons in the north of- France were questioned about their experience with intraoperative and late mandibular fracture after third molar surgery. Cases were examined clinically and radiographically. RESULTS: Thirty-seven fractures were reported in about 750,000 extractions (incidence of 0.0049%). Only 27 cases could be precisely described: 17 intraoperative and 10 late fractures. The patients were 19 to 75 years of age, with an average age of 37 years for intraoperative fractures and 47 years for late fractures. All grades of tooth impaction were included. Only 2 patients did not have full dentition. CONCLUSIONS: The major incidence of immediate and late mandible fractures occurs in patients older than over 25 years. Men may be more likely to have late fractures (8 of 10 cases).     

Use of pressure-formed splints in oral surgery

This article illustrates the scope of use for pressure-formed splints in two frequently encountered fields of oral surgery: maxillary segmental surgery and management of fractures of the mandible through the dental arch. The use of these splints in both fields allows significant modification of generally accepted procedures.     

Three-dimensional, non-destructive visualization of vertical root fractures using flat panel volume detector computer tomography: an ex vivo in vitro case report

AIM: To detect and to visualize radiographically vertical root fractures in extracted teeth with a prototype of a novel, high resolution, three-dimensional flat panel volume detector computer tomograph (FD-VCT) system. SUMMARY: Five teeth with root fillings and clinical symptoms such as fistulas and isolated periodontal pockets of 8 mm or more were extracted after dental radiography indicating lateral or periapical lesions. Vertical root fractures or cracks were suspected because of the symptoms and clinical findings were evident after extraction in all cases but fracture lines were not visible on routine dental radiographs acquired before extraction. The extracted teeth were explored with a prototype of a FD-VCT. Using the FD-VCT, in all cases vertical root fractures or crack lines could be detected clearly in different views, depiction-modes and cross-sections at a spatial resolution of 140 microm. The evaluation of the fracture lines and teeth could be performed in three-dimensional views. The FD-VCT findings were confirmed by detailed inspection of the extracted teeth. KEY LEARNING POINTS: The FD-VCT is an innovative diagnostic tool for non-destructive, three-dimensional evaluation of extracted teeth in pre-clinical and experimental studies. The FD-VCT allows precise visualization and evaluation of vertical root fractures or cracks in extracted teeth. Clinical application of the system may be possible if technical modifications reduce the exposure dose: the high resolution detector systems of the FD-VCT should be combined with radiation systems that focus the radiation to the area of interest.     

Passive repositioning of maxillary fractures: An occasional impossibility without osteotomy

PURPOSE: To present cases where passive repositioning of maxillary fractures was not achievable during surgery, and a method to provide passive occlusal positioning in those cases. PATIENTS AND METHODS: Over a 10-year period, the maxillae of 24 patients with fractures of the maxilla could not be passively repositioned during surgery. In these cases, a Le Fort I osteotomy was performed in addition to reduction and fixation of the other midfacial fractures. RESULTS: All patients had passive restoration of their pretrauma occlusion during surgery. All patients except 1 had maintenance of their pretrauma occlusion at the last follow-up visit (6 weeks or more) following surgery. CONCLUSION: When passive positioning of the maxilla is not possible, a concomitant Le Fort I osteotomy can provide passive positioning of the occlusion.     

颌面部多发性骨折特征的回顾性研究

目的 :探讨面部多发性骨折的特征。方法 :对武汉大学口腔医学院颌面外科近 10年收治的 2 0 4例面部多发性骨折病例进行分析。结果 :面部多发性骨折 3 2 .3 6%发生于 2 0 -2 9岁年龄段 ,男∶女 =3 .86:1,交通事故伤占 61.76%。 63 .45 %的患者有下颌骨骨折。面部多发性骨折的发病率有增加的趋势。结论 :面部多发性骨折有明显的年龄、性别、部位特征 ,交通事故是造成面部多发性骨折的重要因素     

计算机辅助治疗颧上颌骨复合体骨折

目的:探讨计算机辅助治疗技术在颧上颌骨复合体骨折中的应用.方法:总结2008-10-2010-10期间于我科就诊的24例接受计算机辅助治疗颧上颌骨复合体骨折患者的临床资料,术前建立骨折三维模型并利用快速成型(rapid prototyping,RP)技术制作出个性化的实体模型,指导临床进行骨折段的复位与固定.结果:术后...     

鼻骨-眶-筛骨骨折的手术治疗

目的 探讨鼻骨-眶-筛骨（NOE）骨折的临床特点、治疗原则及手术方法。方法2000至2003年北京大学口腔医学院口腔颌面创伤中心收治29例NOE骨折（单纯NOE骨折2例、合并颅面其他骨折27例），临床典型表现为内眦间距增宽、鼻畸形、眼球内陷或下陷伴复视。手术治疗包括骨折复位、眶壁缺损重建、内眦韧带悬吊和鼻成形。术后对眼球内（下）陷和复视的改善情况和NOE区形态指数进行评价。结果术后3-6个月复查率48．27％。术后感染率10．35％。14例眶壁修复术后，9例眼球内（下）陷得到矫正，5例显著改善；13例内眦韧带悬吊术后，内眦畸形明显改善；4例术后出现慢性泪囊炎，摘除泪囊或行内镜鼻腔泪囊吻合术。22例手术前后形态测量值及相关指数比较：术后内眦间距变小、内眦处鼻梁矢状高度增大，鼻根指数接近正常值、睑裂对称指数97．5％、内眦处鼻梁矢状高度对称指数89．7％。结论根据畸形特征采用多种术式组合治疗NOE骨折，多数可取得较满意的效果，但存在较大的不确定性，对眼球内陷和内眦畸形的手术矫治方法还有待进一步研究和改良。     

Craniofacial traumas: immediate and delayed treatment

In 1998, 28 patients with craniofacial fractures have been under observation at the Emergency Room of the Policlinico Umberto I of Rome. Twenty-six patients have undergone reduction and contention surgery of the fractures. The diagnosis of the fractures has been achieved through CT axial scanning and coronal reconstruction as well as with three-dimensional CT. The CT spiral was used in those cases that required more rapid intervention, whereas the MRI was used to evaluate the condition of the eyeball. Twenty of such patients underwent surgical treatment a few hours after the trauma and, in such cases, excellent aesthetic and functional results were achieved. The general and neurological conditions of six patients did not permit prematurely proceeding with surgery. Two patients died a few hours after the trauma of the injuries sustained. Of the six patients who underwent delayed treatment, acceptable functional and aesthetic results were achieved in four, whereas the remaining two patients had inadequate results. The results we have obtained show that it is possible to achieve the best results, both aesthetic and functional, through immediate treatment. Delayed treatment is carried out at least 2 weeks after the trauma because of the patient's condition and presents reconstruction difficulties that do not guarantee a satisfactory aesthetic reconstruction as well as, in some cases, an effective functional restoration.