上颌骨三维重建术后患者咀嚼功能的评价

目的　评价三维重建上颌骨大型缺损术后患者咀嚼功能的恢复程度。方法　选择2001年3月~2002年6月经上海第二医科大学附属第九人民医院口腔颌面外科治疗的大型上颌骨缺损患者10例为研究对象。运用个体化钛网支架结合前臂皮瓣或串联腓骨肌瓣的新术式行大型上颌骨缺损即刻重建,术后3~6个月常规可摘局部义齿修复。采用美国Tekscan公司生产的T-ScanⅡ诊断系统行患者术前、术后的力与咬合测定分析。结果　患者术前、术后力不对称指数与接触面积不对称指数均存在显著差异(P<0·05);义齿恢复咬合后,全口力恢复率在27·05%~74·06%,平均力恢复率为(50·15±14·59)%。结论　本术式可使大型上颌骨缺损即刻重建的患者获得外形与功能较为满意的效果,可有效地恢复患者的咀嚼功能,具有一定的推广和应用价值。

Evaluation of Mastication Function after Three-dimensional Maxillary Reconstruction

OBJECTIVE: To evaluate the mastication function of the patient whose maxilla was reconstructed with individual titanium mesh and Chinese flap or combined with fibular flap. The superiority of this method on maxillary functional reconstruction was testified. METHODS: Since March of 2001, 10 cases of maxillary defect were reconstructed with individual titanium mesh and Chinese flap or combined with fibular flap, and routine removal partial dentures were fixed after 3 - 6 months postoperatively. Assessment of occlusal force was proceeded by T-Scan II system (Tekscan company, USA). RESULTS: The occlusal force analysis results indicated the asymmetry index of bite force and asymmetry index of occlusal contact area differed significantly between preoperation and postopertion (P < 0.05). The recovery rate of total occlusal force was between 27.05%-74.06%, and the average was 50.15%. CONCLUSION: This new three-dimensional maxillary functional reconstruction method had a satisfactory recovery in both of contour and function recently, especially restored the mastication function effectively.