麻风患者的口腔及颌面部损害

对广东省8所麻风院村1155名(现症237名,治愈留院918名)病人进行口腔颌面7个方面38项检查,其中男911名,女244名;年齿15～90岁,平均55.7岁。多菌型842名,少菌型308名,类型不详者5名。1155人中面容受损者994人(86.1％);面部感觉障碍者483人(41.8％),面部上2/3感觉障碍多于下1/3,此两项损害均为病程愈长损害率愈高。眶上神经粗大333人(28.8％),其中兼有感觉障碍者110人,占神经粗大者的33％。接受微安电流牙髓神经感觉测试者770人,无反应者291人(37.8％),多菌型中无反应者232人(41.1％),少菌型中59人(29.2％),P>0.01,其临床及诊断意义有待进一步探讨。口腔内组织实质性破坏多表现在腭部,多菌型中109人(12.9％),少菌型16人(5.2％),P>0.01。麻风患者口腔卫生欠佳,患龋率为84.5％,龋均5.23颗,牙周病检出率为76.8％,牙齿丧失率为69.5％,平均缺牙7.7颗,与正常人比较均偏高,可能是由于被隔离而失去了求治牙病的条件及口腔科专业人员忽视了对他们的关心。作者认为对麻风患者牙功能的重建应属麻风康复工作的内容之一。     

AUTOGENOU8 BOILED TUMOR BONE IMMEDIATE GRAFTING OF THE MANDIBLE

When cert,aiu bone tumors require the re- moval of an entire segment of the mandible, autogenous bone irmnediate graft,ing after man- dibular resection is a widely accepted technic in current maxilloracial hone surgcry. The rlb and iliac crest are generally cons:dered to be the best materials tor this purpose. But the disadvanfages of these appruaches are obvious. The author proposes the use of autogenous boiled tumor bone instead. IJsing the author's technic operations were performed upou 5 pa- tients with various mandibular tumors. Four cases achieved wound healing at first intention. In l of these new bone formation xvas revealed oii radiagraphs and nonnal mandibular func- tion was restored. The other 3 cases showed no sequelae at short-ierm follow-up. ' Analysis is made of the causes of the l failure. The technic of autogenaus boited tumor bone jm— mediate grafting is brielily described and its advantages are evaluated. The author feels that use of boilcd autogenous tumor bone in- stead of autogenous fresh bone is feasible in selected cases, including malignant tumor.