火器伤牙槽突缺损的牵张成骨治疗(1)
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[摘要]目的:探讨牵张成骨技术治疗火器伤牙槽突缺损的临床应用。方法:2例患者分别因火枪和炸药爆炸导致下颌骨牙槽突缺损,一期经清创处理,遗留严重牙槽突缺损,影响义齿修复,接受牵张成骨治疗,其中1例行垂直骨牵张,另1例接受水平骨牵张。结果:2例患者均顺利完成治疗,垂直骨牵张升高牙槽突约7mm,水平骨牵张牙槽突恢复长度约16mm,X线显示成骨良好。结论:牵张成骨技术可以有效地修复火器伤牙槽突缺损,并为最终重建咬合关系和实现功能性修复提供了基础,为火器伤的救治提供了一条新的修复方法,值得临床借鉴和推广。
[关键词]牵张成骨;火器伤;牙槽突缺损;修复
[中图分类号]R782.4 [文献标识码]A [文章编号]1008-6455(2010)10-1469-04
Clinical application of distraction osteogenesis techniques in alveolar defects wounded by firearm
CHEN Shu-jun1,JI Ning2,HAN Xiao-xian1,NIU Xue-gang1,CHEN Yu-xuan1,LIN Xue-mei1,LIU Rui-feng1,WEI Xiao-zong1,LIU Yan-kun1
(1.Department of Stomatology,252nd Hospital of PLA,Baoding 071000,Hebei,China;2. Department of Infection and Quality control, 252nd Hospital of PLA)
Abstract: ObjectiveTo investigate the clinical application of distraction osteogenesis techniques in alveolar defects wounded by firearm.MethodsSerious alveolar defects were remained in 2 patients wounded by firearm after first-stage debridement, causing increasing difficulty in denture.Distraction osteogenesis techniques were used for the solution with horizontal distraction in one case and vertical distraction in the other. Results The two patients were performed as planned. The amounts of distraction were 7mm in horizontal distraction, and 16mm in the vertical distraction. All the territories showed good new bone by X-ray examination. Conclusion Distraction osteogenesis was an effective method for the repair of alveolar defects wounded by firearm,which sets a foundation for further occlusal reconstruction and functional repair. This technique provides a new approach for the treatment of alveolar defects wounded by firearm and is good for popularize.
Key words:distraction osteogenesis;firearm wound;alveolar defects;repair
由于外伤、肿瘤、牙周病等原因引起的牙槽骨高度严重不足往往给义齿修复带来困难,传统的植骨术和骨引导再生技术(guided bone generation,GBR)由于受到软组织量不足等问题,限制了其临床应用[1]。牵张成骨在颌面部骨缺损治疗上的应用为牙槽突缺损的治疗提供了新的手段。它通过某种牵张装置,使骨切开处的骨组织受到缓慢而稳定的牵引和张力,激活细胞的增殖与合成功能,促使组织的再生,从而达到增长和伸直骨骼的目的[2-3]。由于火器伤本身特点,其所造成的骨折往往是粉碎性的,针对牙槽突,这种骨折碎片常无法保留,从而造成严重的牙槽突缺损[4]。我科采用牵张成骨技术成功治疗2 例火器伤牙槽突缺损患者。现报道如下。
1资料和方法
1.1 临床资料:共2例患者,均为女性,年龄分别为24岁和30岁,致伤原因为火枪伤和爆炸伤(见表1) ......
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