牵张成骨术在严重牙颌面缺损畸形联合治疗中的应用

目的探讨以牵张成骨术治疗严重牙颌面缺损畸形的效果。方法对2006年12月—2010年3月收治的多类牙颌面缺损畸形患者6例,一期使用内置式牵引器进行牵张成骨术延长,二期采用正颌外科、腓骨瓣移植等方法矫治,配合正畸、牙种植体等修复方法治疗。结果 6例均顺利完成治疗,所有患者牵张成骨术后新骨生成良好,最小牵引成骨距离7 mm,最长30 mm,均达到预期牵张目的,无严重并发症发生。经二期常规外科手术及修复治疗后咬合关系和面形均得到恢复。结论牵张成骨术可以有效地修复多种颌面骨缺损或畸形,在严重牙颌面缺损和畸形序列治疗中具有良好的效果,为重建咬合关系和实现功能性修复提供基础。

Application of Intraoral Distraction Osteogenesis in Treatment of Serious Teeth-maxillofacial Deformity

Objective To explore the effect of intraoral distraction osteogenesis in treatment of severe teeth-maxillofacial deformity. Methods A total of 6 patients with severe teeth-maxillofacial deformity during December 2006 and March 2010 underwent the first operation with intraoral distraction osteogenesis techniques. At the second stage,modification treatments of orthognathic surgery and fibula flap transplantation combined with restorative procedures were performed. Results All the patients underwent operations successfully. The new bone formation was good in all patients after distraction osteogenesis without severe complications,and the minimum distance of distraction was 7 mm,the maximum was 30 mm. The occluding relation and deformity were corrected satisfactorily after the second stage treatment.Conclusion The segmental defect or abnormalities of jaw bones can be reconstructed with intraoral distraction osteogenesis techniques,and has good effect in sequence treatment of severe teeth-maxillofacial deformity,which can provide basis for occluding relation reconstruction and functionality repair.