严重口腔颌面外伤患者的临床处理措施

目的对严重口腔颌面外伤患者的临床处理措施进行分析。方法选取我院2012年10月至2013年10月所接受治疗的38例严重口腔颌面外伤患者,对其临床资料进行回顾性分析,以对其临床处理措施进行总结。结果经过有效处理,38例患者的临床治愈36例,治愈率为94.74%,无效2例,无效率为5.26%。结论在严重口腔颌面外伤患者中临床治疗中,一定要及时采取有效处理措施,这样才能够对患者临床治愈率提高,改善患者生活质量。     

Custom-Made Zirconium Dioxide Implants for Craniofacial Bone Reconstruction

Reconstruction of the facial skeleton is challenging for surgeons because of difficulties in proper shape restoration and maintenance of the proper long-term effect. ZrO₂ implant application can be a solution with many advantages (e.g., osseointegration, stability, and radio-opaqueness) and lacks the disadvantages of other biomaterials (e.g., metalosis, radiotransparency, and no osseointegration) or autologous bone (e.g., morbidity, resorption, and low accuracy). We aimed to evaluate the possibility of using ZrO₂ implants as a new application of this material for craniofacial bone defect reconstruction. First, osteoblast (skeleton-related cell) cytotoxicity and genotoxicity were determined in vitro by comparing ZrO₂ implants and alumina particle air-abraded ZrO₂ implants to the following: 1. a titanium alloy (standard material); 2. ultrahigh-molecular-weight polyethylene (a modern material used in orbital surgery); 3. a negative control (minimally cytotoxic or genotoxic agent action); 4. a positive control (maximally cytotoxic or genotoxic agent action). Next, 14 custom in vivo clinical ZrO₂ implants were manufactured for post-traumatologic periorbital region reconstruction. The soft tissue position improvement in photogrammetry was recorded, and clinical follow-up was conducted at least 6 years postoperatively. All the investigated materials revealed no cytotoxicity. Alumina particle air-abraded ZrO2 implants showed genotoxicity compared to those without subjection to air abrasion ZrO₂, which were not genotoxic. The 6-month and 6- to 8-year clinical results were aesthetic and stable. Skeleton reconstructions using osseointegrated, radio-opaque, personalized implants comprising ZrO₂ material are the next option for craniofacial surgery.     

口腔颌面囊肿及囊性病变行开窗引流术治疗的效果

目的分析和研究在口腔颌面囊肿及囊性病变的治疗过程中,采用开窗引流术治疗的效果。方法选择的研究对象为我院2018年12月到2019年12月期间内所收治的68例口腔颌面囊肿及囊性病变患者,按照抽签的方式分为观察组和对照组,其中对照组采用传统开放性手术治疗,观察组采用开窗引流术治疗,分析和对比两组的手术治疗情况(手术时间、术中出血量以及住院时间)、手术成功率、术后感染率、疾病复发率。结果两组患者治疗完成之后,观察组的手术治疗情况、手术成功率、术后感染率、疾病复发率均明显优于对照组,并且将所有数据指标进行相关对比,差异十分明显,有统计学意义(P<0.05)。结论在口腔颌面囊肿及囊性病变的治疗过程中,采用开窗引流术治疗具有较好的临床疗效,值得推广使用。     

Morphometric study of the scapular free flap and the free rib osteomyocutaneous flap

The scapula free flap is often the first choice for reconstruction of bony defects of the facial skeleton. However, the vascularised rib as part of a free rib osteomyocutaneous flap may be a suitable second choice. We have investigated the morphology and clinical dimensions of the 7th rib and the scapula, and the ability of the available bone to carry dental implants. The age and sex of the cadaver, and the donor side, were also recorded. The dimensions of the scapulas and 7th ribs (n = 130 of each) from 65 cadavers were measured at 4 different points using osteometric methods. Examination showed that bone from the scapula and 7th rib were sufficient for placement of implants. The 7th rib gave reliable measurements for both height and width, and a consistent relation between compact and cancellous bone. Although the scapula provided adequate compact and cancellous bone, there were variations depending on the segment of bone chosen. Bones from male cadavers were more suitable for implantation. In both the scapula and the 7th rib ageing had a significant adverse effect in only one dimension. Most points of measurement have satisfactory bony dimensions for insertion of dental implants.     

Specialist titles used in clinical correspondence: a UK survey of oral and maxillofacial surgery consultants

We explored how oral and maxillofacial (OMF) consultants describe themselves in their correspondence. We did a telephone survey of OMF surgeons’ secretaries and compiled data on the specialist titles used. Data were available for 290 consultants and 19 different titles were identified. A total of 190 (66%) consultants used the title OMF surgeon alone and a further 22 (8%) combined it with the name of a subspecialty. The remaining 78 (27%) used 11 alternative titles. Of those surveyed, 212 (73%) continue to use the specialty title of OMF surgeon with or without the name of a subspecialty comprising a readily identifiable group of specialists.     

口腔颌面部高速投射物伤致牙周膜间接损伤的实验研究

目的：研究口腔颌面部高速投射物伤导致的牙周膜间接损伤的特点。方法：将18只实验犬随机分为6组,以直径6．0 mm、质量0．88 g的高速投射物致伤右下颌骨体部第四前磨牙根尖下方区域,但不直接伤及牙齿;分别于伤后6h、24h、3d、7d、2w及4w处死实验犬,观察右下颌第四前磨牙、第二前磨牙及左下颌第二前磨牙牙周膜的组织病理学表现。结果：右下颌第四前磨牙和第二前磨牙的牙周膜损伤较明显,但病理学变化可逆;左下颌第二前磨牙牙周膜仅见一过性血管扩张、充血。结论：口腔颌面部高速投射物伤可导致牙周膜发生间接损伤,病理学变化可逆;损伤程度随着牙齿与伤区距离的增加而递减。     

正畸正颌联合治疗唇腭裂术后牙颌面畸形的疗效观察

目的:探讨正畸、正颌外科联合治疗唇腭裂术后牙颌面畸形的临床疗效。方法:选择2001—2012年,我院收治的唇腭裂术后牙颌面畸形患者56例,采用正颌联合正畸的方法进行治疗。随访6²4个月,观察牙颌面畸形改善情况。结果:56例患者面形改善明显,咬合关系良好,随访无复发。比较手术前后的头影测量值进行分析,差异具有统计学意义(P<0.05)。结论:正颌外科联合术前、术后正畸,可明显改善面部畸形,减少术后复发,是治疗唇腭裂术后牙颌面畸形的理想手术方式。