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Le FortⅠ型截骨术矫治上颌骨陈旧性骨折错牙合畸形

乔峰   

  1. 天津医科大学口腔医院
  • 收稿日期:2010-12-08 修回日期:2011-06-02 出版日期:2011-11-15 发布日期:2011-11-15
  • 通讯作者: 乔峰

The Correction of Malocclusion of Old Maxilla Fracture with Le FortⅠOsteotomy

  • Received:2010-12-08 Revised:2011-06-02 Published:2011-11-15 Online:2011-11-15

摘要: 摘要 目的: 探讨上颌骨陈旧性骨折牙颌畸形患者实施Le FortⅠ型截骨术及坚固内固定(RIF)矫治方法的临床效果。方法: 选择2007年6月—2010年10月天津医科大学口腔医院外科收治的上颌骨陈旧性骨折错位愈合而致错牙合畸形患者27例,经术前术后软硬组织X线头影测量分析、术前手术模拟预测(STO)分析、模型外科分析后,采用Le FortⅠ型截骨术及RIF手术治疗。测量结果术前术后对比分析。结果: 27例患者均获得满意的咬合功能和颜面形态。 硬组织指标上颌突度、上颌突距和上前牙槽高在手术后较手术前减小,而上面高则较术前增加(P<0.05或P<0.01)。软组织指标面中份突度和上唇至审美平面距较术前减小,而鼻唇角和上面高较术前增加(P<0.05或P<0.01)。术后3~6个月随访无复发。结论:Le FortⅠ型截骨术+ RIF矫治上颌骨陈旧性骨折所致颜面畸形和咬合功能障碍可取得满意效果。

关键词: 陈旧性骨折, LEFORTⅠ型截骨, 坚强内固定, STO分析

Abstract: Abstract objectives: To study the possibility of Le FortⅠosteotomy correction for old maxillary fracture and to evaluate the clinical efficacy. Methods: Twenty-seven patients with old maxilla fracture were treated by Le Fort I osteotomy based on pre- and postoperative cephalometric and preoperative simulation and prediction (STO)analysis with RIF. Model surgery was performed on dental casts preoperatively. The pre-and postoperative measurements were compared with each other. Results: All cases healed well and had satisfactory occlusal function and facial form. The values of maxillary protrusion (SNA),upper jaw protrusion distance (sn-g)and the cutting edge of central incisor to the palatal plane points (U1-pp) were decreased after operation than those of before operation (P<0.05),but the value of N-ANS was increased(P<0.05). The values of G-Sn (//HP) and Ls-EP(⊥EP) were significantly decreased(P<0.05) after operation than those of before operation, but Cm-Sn-Ls and G-Sn(⊥HP) were increased compared with those of before operation (P<0.05). There was no recurrence after 3 - 6 months follow-up. Conclusion: Reconstruction of the maxillary with Le Fort I osteotomy is an effective method to treat delayed panfacial fractures.

Key words: old fracture, Le FortⅠOsteotomy, Rigid Internal Fixation, STO analysis