口内入路与口外入路治疗下颌角骨折的疗效比较

上海口腔医学 ›› 2016, Vol. 25 ›› Issue (4): 500-510.

口内入路与口外入路治疗下颌角骨折的疗效比较

张伯俊, 王卫红, 许彪

昆明医科大学附属口腔医院口腔颌面外科,云南昆明 650031

收稿日期:2015-07-13 出版日期:2016-08-25 发布日期:2016-09-06
通讯作者: 王卫红,E-mail:wwh2002191@gmail.com
作者简介:张伯俊（1988-）,男,硕士研究生,
基金资助:
云南省高等卫生技术学科带头人项目（D-201233）

Treatment of mandibular angle fracture through intraoral and extraoral approach: a comparative study

ZHANG Bo-jun, WANG Wei-hong, XU Biao

Department of Oral and Maxillofacial Surgery, Affiliated Stomatology Hospital of Kunming Medical University. Kunming 650031, Yunnan Province, China

Received:2015-07-13 Online:2016-08-25 Published:2016-09-06

摘要/Abstract

摘要： 目的探讨口内入路与口外入路治疗下颌角骨折的临床疗效。方法对2008年1月—2014年12月收治的46例下颌角骨折患者进行回顾分析,患者分为2组,第1组22例患者采用口内入路,用1块宽2.0 mm小钛板复位固定。第2组24例患者采用常规下颌下入路,用2块2.0 mm钛板复位固定。术后均行颌间弹力牵引3周。采用SPSS 13.0软件包对数据进行统计学分析。结果术后3周第1组患者无感染及口角歪斜发生;第2组患者5例出现感染,3例出现暂时性口角歪斜。3个月后复诊,第1组患者切口愈合良好,骨折断端愈合良好,咬合关系恢复良好,开口度正常;第2组患者3例出现骨折愈合不良,再次手术取出钛板,咬合关系欠佳。结论对于下颌角骨折,采用口内入路复位固定同样可以达到良好的治疗效果;与口外常规下颌下切口相比,口内切口创伤小,美观,不会损伤面神经,术后并发症少,手术成功率高。

关键词: 下颌角骨折, 口内入路, 口外入路, 下颌第三磨牙

Abstract: PURPOSE: To compare the clinical effects of mandibular angle fracture surgery through intraoral and extraoral approach. METHODS: From January 2008 to December 2014, 46 patients with mandibular angle fracture were retrospectively recruited in this study. An intraoral approach was used in 22 cases as group 1 in whom the fractures were fixed by one titanium miniplate alone, the others through an extraoral approach as group 2 in whom the fractures were fixed by two plates. Intermaxillary traction was used in all patients for 3 weeks following the operation. The data was collected in MS Excel 2003 and further analyzed by SPSS13.0 software package. RESULTS: The wound healing was in uneventful group 1, no complication occurred 3 weeks later. On the contrary, 5 cases with postoperative infection and 3 cases with temporary weakness of facial nerve were observed in the group 2. Three months later, postoperative panoramic radiographs showed mandible fractures healed well in group 1; while in group 2, three cases complained of unhealed fractures and unsatisfactory occlusion. CONCLUSIONS: Compared with extraoral approach to manage mandibular angle fracture with 2 miniplates, one miniplate through intraoral approach can provide better outcomes.

Key words: Mandibular angle fractures, Intraoral approach, Extraoral approach, Mandibular third molars

中图分类号:

R782.4

张伯俊, 王卫红, 许彪. 口内入路与口外入路治疗下颌角骨折的疗效比较[J]. 上海口腔医学, 2016, 25(4): 500-510.

ZHANG Bo-jun, WANG Wei-hong, XU Biao. Treatment of mandibular angle fracture through intraoral and extraoral approach: a comparative study[J]. Shanghai Journal of Stomatology, 2016, 25(4): 500-510.

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