口内入路磨削法下颌缩小成形术

目的探讨口内入路磨削法下颌缩小成形术的临床效果及操作要点。方法对598例采用口内入路磨削法下颌缩小成形术，磨削范围包括咬合线以下的升支后缘及下齿槽管外侧的下颌骨外板、下颌角、部分升支下部及颏孔后部分的下颌缘全层骨质。术前、术后摄取头颅定位正、侧位X线片和照片。结果磨削后下颌骨升支下部和体部缩窄，下颌角缩小并提升，外形改善明显，下颌角角度、下颌平面角、前颅底平面角、面下宽度均较术前明显改变（P〈0．01）。术后随访168例，优良率为95．24％。结论口内入路磨削法下颌缩小成形术，可以在矫正下颌角肥大的同时去除部分下颌骨外侧皮质层，基本可以达到下颌角截骨术和骨外板劈除术的效果，且操作准确、简便易行。

Intraoral approach for abrasive mandibular reduction osteoplasty

Objective To verify the clinical reliability of a simple abrasive method for reduction mandibular osteoplasty.Methods A total of 598 cases of reduction mandibular osteoplasty were performed by using the abrasive method since 2002.Through intraoral incisions,the low part of mandibular ramus,angle region,buucal cortice and inferior border of mandible were exposed and abrasive osteoplasty was taken with special designed retractors,rasp and grinding burs with protecting sheath.The inferior alveolar nerve could be preserved.Results There was no nerve injury and only one hemorrhage case during operation without unfavorable result.In 6 to 1～2 months follow-up for 168 cases,the satisfactory rate for contour results was 95.24%.Conclusion Through the intraoral approach,the abrasive mandibular reduction osteoplasty is a simple,safe and effective method for mandibular osteoplasty.It is not to correct the prominent mandibular angle but to reduce the thickness of the mandibular ramus and body.This method could contribute the same results of angle ostectomy and split cortical bone ostectomy and result a good contour of the jaw region.