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下颌骨折

下颌骨折的相关文献在1989年到2022年内共计148篇,主要集中在口腔科学、外科学、临床医学 等领域,其中期刊论文124篇、专利文献13164篇;相关期刊82种,包括医学临床研究、中华创伤杂志、口腔材料器械杂志等; 下颌骨折的相关文献由399位作者贡献,包括孙广平、张益、李祖兵等。

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论文:13164 占比:99.07%

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下颌骨折

-研究学者

  • 孙广平
  • 张益
  • 李祖兵
  • 李肇元
  • 赵仪云
  • 丁喜发
  • 代杰文
  • 刘三霞
  • 刘昌奎
  • 吴义青
  • 期刊论文
  • 专利文献

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    • 魏继兵; 何中恒; 李志; 王新; 刘会林; 娄志鸿
    • 摘要: 目的 探究颌后入路与颌下入路对下颌骨髁突骨折患者张口度和面神经损伤的影响.方法 选取2016年7月1日至2020年1月1日开封市中心医院收治的80例下颌骨髁突骨折患者作为研究对象,根据随机数字表法分为对照组和观察组,每组40例.对照组给予颌下入路治疗,观察组给予颌后入路治疗.比较两组术后临床疗效.结果 观察组术后3个月、6个月张口度、胎关系正常率、治疗总有效率高于对照组,而术后面神经损伤率、口偏斜率、涎瘘和切口感染发生率低于对照组,差异有统计学意义(P<0.05).结论 颌后入路对中低位下颌骨髁突骨折患者的治疗,可有效提升患者张口度,降低面部神经损伤和术后并发症发生率,提高临床治疗效果.
    • 孙国文; 黄蓉; 刘喆; 陈昊亮; 田美; 王丹妮
    • 摘要: 目的 探讨下颌骨后缘小切口穿腮腺入路在髁突中低位骨折切开复位内固定术中的应用效果.方法 回顾分析2016年1月至2019年1月,于南京市口腔医院采用下颌骨升支后缘小切口穿腮腺入路行骨折复位的28例下颌骨髁突骨折患者的临床资料.其中男18例,女10例,平均年龄42.5岁;左侧髁突骨折11例,右侧13例,双侧4例.术中于下颌骨后缘,切开皮肤、皮下组织,切口长度为2~3 cm,平行于面神经走行钝性分离,直接穿过腮腺及咬肌,不必刻意解剖面神经,暴露骨折线后,直视下以2块4孔钛板复位固定骨折断端.于术后3d及3~6个月期间进行临床及影像学检查、评估,内容包括:术后血肿、术后感染、神经损伤、涎瘘、最大张口度、张口型、咬合关系、瘢痕情况等.结果 28例患者骨折断端均复位良好,无神经损伤,涎瘘等并发症,仅有1例患者术后发生感染,3个月后进行二次手术取出钛板.所有患者出院时张口度为1.5~3.8 cm,平均3.1 cm,较手术前(0.5~2.0cm,平均1.2 cm)均有明显改善.1例患者开口时颏部稍偏向患侧,术后配合颌间弹性牵引3~5d,咬合关系恢复良好.其余患者张口口形均基本正常.随访6~36个月,所有患者术后瘢痕均不明显,患者对手术效果表示满意.所有患者于术后3~6个月拍摄术后CT及三维重建,均显示骨折复位良好.结论 下颌升支后缘小切口穿腮腺入路对于治疗髁突中低位骨折效果良好、方法简单、高效、快捷,不需要解剖面神经,不仅能够减少手术时间,降低损伤面神经的可能性,而且术后瘢痕也较隐蔽.
    • 班强; 李俊
    • 摘要: 髁突是下颌骨骨结构的薄弱区域之一,外伤后易发生骨折且复位难度大,固定困难,手术要求高.其中以髁状突矢状骨折(sagittal fracture of the mandibular condyle,SFMC)最难诊治,作为髁突囊内骨折的重要分类,因其局部解剖结构复杂,故手术难度大、风险高.国内外学者关于髁状突囊内矢状骨折是应采用保守治疗还是采用手术治疗一直存在着争议,随着外科技术的提高、固定方法的改进和固定材料的发展,目前认为手术治疗更有利于功能重建的观点得到更广泛的认同.本文将从髁状突囊内矢状骨折的手术治疗适应证和手术治疗两大方面进行综述.
    • 李铀; 曾勇; 吕俊; 李志刚; 张纲; 汪维健; 谭颖徽
    • 摘要: Objective To investigate the value of computer aided design and 3D printing model in operation for complex mandibular fractures.Methods The clinical data of 136 patients with complex mandibular fractures treated from June 2006 to June 2016 were retrospectively analyzed.The patients were divided into 3D group (n =28) and conventional group (n =108) based on the use of computer aided design and 3D printing model.There were 24 males and four females in 3D group,with the age of (33.8 ± 15.4) years.There were 91 males and 17 females in conventional group,with the age of (30.3± 11.9)years.The 3D group used computer aided design and 3D printing model to develop the surgical plan,and the conventional group used traditional CT scan image data.The operation time,intraoperative blood loss,incidence of postoperative adverse events,and the distance differences between the ipsilateral and the five contralateral maxillofacial markers were compared between the two groups (△L1:the difference between the mandibular angle point and the condyle apex;△L2:the difference between the mandibular angle point and the chin vertex;△L3:the difference between the apex of the chin and the apical point;△L4:the difference between the inner mandibular angle point and the Inferior alveolar margin point;△L5:the distance between the inner mandibular angle and the sagittal plane).Results The operation time in the 3D group and the conventional group were 155 (126.25,183.75)min and 235 (156.25,268.75)min,respectively.The intraoperative blood loss in the 3D group and the conventional group were 100 (50.0,187.5) ml and 125 (100.0,200.0) ml,respectively.In the 3D group,one patient had mild occlusion disorder.In the conventional group,4 patients had postoperative infection,1 repulsion reaction of internal fixation device,and 19 mild occlusion disorder.The differences between the two groups in operation time and postoperative adverse events were statistically significant (P < 0.05),but there was no significant difference in intraoperative blood loss (P > 0.05).There was no significant difference between the ipsilateral △L and contralateral △L in two groups (P > 0.05).No significant difference in △L4 was found (P > 0.05),but there were significant differences in △L1,△L2,△L3,and △L5 between the two groups (P <0.05).Conclusion For patients with complex mandibular fractures,the use of computer-aided design and 3D printing model can helps shorten operation time,reduce postoperative adverse events and hence improve the fracture reduction outcome.%目的 探讨计算机辅助设计及3D打印模型在复杂下颌骨骨折手术中的应用价值.方法 采用回顾性病例对照研究分析2006年6月—2016年6月手术治疗的136例复杂下颌骨骨折患者临床资料,根据是否使用计算机辅助设计及3D打印模型分为3D组和常规组.3D组28例,其中男24例,女4例;年龄(33.8±15.4)岁.常规组108例,其中男91例,女17例;年龄(30.3±11.9)岁.3D组采用计算机辅助设计及3D打印模型制订手术计划,常规组采用传统CT平扫影像资料制订手术计划.比较两组手术时间、术中出血量、术后不良事件发生率,以及患侧与健侧5个颌面部标志点距离差值(△L)(△L1为患侧与健侧下颌角点至髁顶点距离差值;△L2为患侧与健侧下颌角点至颏顶点距离差值;△L3为患侧与健侧颏顶点至髁顶点距离差值;△L4为患侧与健侧内下颌角点至下牙槽缘点距离差值;△L5为患侧与健侧内下颌角点至中矢状面距离差值).结果 3D组和常规组手术时间分别为155(126.25,183.75)min、235(156.25,268.75)min,术中出血量分别为100(50.0,187.5) ml,125(100.0,200.0) ml.3D组中1例出现轻度咬合关系紊乱;常规组中4例出现术后感染,1例内固定装置排斥反应,19例轻度咬合关系紊乱.两组手术时间、术后不良事件发生率差异有统计学意义(P<0.05),术中出血量差异无统计学意义(P>0.05).两组患者下颌骨健侧和术前患侧的5个线距测量值差异无统计学意义(P>0.05),两组△L4差异无统计学意义(P>0.05),△L1,△L2,△L3,△L5差异均有统计学意义(P<0.05). 结论 对于复杂下颌骨骨折患者,计算机辅助设计及3D打印模型的使用有助于缩短手术时间,降低术后不良事件发生率,提高骨折复位效果.
    • 朱妍菲; 唐艳梅; 孙蕙珺; 于倩; 朱敏
    • 摘要: 目的 评价2~15岁单侧髁突骨折患者双侧髁突及颞下颌关节区的对称性,分析保守治疗后髁突生长改建的差异.方法 收集2016年6月至2017年3月于上海交通大学医学院附属第九人民医院口腔颅颌面科就诊的23例单侧髁突骨折行保守治疗并随访1年及以上2~15岁患者的全头颅螺旋CT数据,导入Simplant 11.04软件进行三维重建,对相关解剖结构三维定点、设定测量项目后,测量颞下颌关节窝深度、关节结节高度,髁突的长度、宽度及厚度和骨性颏点偏斜程度,比较患侧与健侧髁突及邻近结构的生长情况.结果 23例患者患侧关节结节最下点到眶耳平面的距离与健侧差异无统计学意义(P=0.110),患侧颞下颌关节窝最上点到眶耳平面的距离显著大于健侧(P=0.010);患侧髁突长度显著小于健侧(P=0.002),患侧髁突宽度显著大于健侧(P=0.002),患侧髁突厚度与健侧差异无统计学意义(P=0.071);骨性颏点向患侧偏斜(0.69±1.75) mm,患侧与健侧颏点偏斜程度差异无统计学意义(P=0.072).结论 短期随访发现保守治疗后患儿骨折侧髁突的生长能力较正常侧差,但通过颞下颌关节窝骨质增生以代偿髁突高度不足,骨性颏点未发现偏斜.%Objective To investigate the influence of condylar fractures on the growth of condylars after conservative treatments by three-dimensional measurement.Methods Twenty three children with unilateral condylar fracture followed-up for at least 1 year in Shanghai Ninth People's Hospital were included from June 2016 to March 2017.CT scans were performed for each patient.Three-dimensional virtual skulls were reconstructed and measuring points were defined with Simplant 11.04 software.The depth of glenoid fossa,height of articular eminence,width,height and depth of condylar,deviation of pogonion were measured.Statistical analyses were conducted to assess difference between the bifid group and the normal group.Results No difference was observed in the vertical position of crest of the articular eminence between two groups (P=0.110).The vertical position of roof of the glenoid fossa in bifid side was significantly superior than the one in normal side (P=0.010).Bifid side had a shorter (P=0.002) and wider (P=0.002) condylar than normal side did.No difference was observed in the depth of condylar between two groups (P=0.071).The average deviation of pogonion was (0.69± 1.75) mm (P=0.072) from sagittal plan.Conclusions This short-termed study indicates that children's growth potential of condylar is under average after conservative treatments.Because the bone hyperosteogeny of glenoid fossa compensates the hypotrophy of condylar,no deviation of pogonion is detected.
    • 刘磐; 柏舒科; 彭利伟; 马钊
    • 摘要: 目的 探讨面神经下颌缘支与下颊支间的相对安全的解剖位置,为颌后穿腮腺入路治疗成人髁突基部骨折提供参考.方法 对20例来源于郑州大学解剖教研室的成人单侧头颅尸体标本进行解剖,测量并观察口角平面(自然闭口状态下,经过口角并平行于眶耳平面的平面)在下颌支后缘附近与面神经下颌缘支和下颊支的位置关系,测量C点(口角平面与下颌支后缘的交点)与D点(口角平面与面神经下颊支最下支的交点)的距离.结果 20例标本中1例因面神经下颌缘支和下颊支均起始于下颌支后缘前方,与下颌支后缘无交叉而排除;18例口角平面在下颌支后缘处恰好位于面神经下颌缘支与下颊支之间,1例标本口角平面在下颌支后缘处位于面神经下颌缘支和下颊支之下.C点与D点的距离为(14.96±8.55)mm,95%置信区间为10.23~19.69 mm.结论 大多数情况下口角平面在下颌支后缘附近位于面神经下颌缘支与下颊支之间,沿口角平面、下颌支后缘前方约1.0 cm范围内为面神经下颌缘支与下颊支间的一个相对安全的位置.%Objective To investigate the relationship between the inferior buccal branch and mandibular marginal branch of the facial nerve in the plane of angulus oris. Methods Twenty unilateral adults cadaveric heads were dissected. In the vicinity of the posterior border of mandibular ramus, the positional relationship between mandibular marginal branch and the plane of angulus oris, the inferior buccal branch and the plane of angulus oris was recoded and analyzed. Results In 18 of the 20 samples, the plane of angulus oris was between the inferior buccal branch and mandibular marginal branch in the vicinity of the posterior border of mandibular ramus. In one sample, the plane of angulus oris was below the inferior buccal branch and mandibular marginal branch in the vicinity of the posterior border of mandibular ramus. Another sample was excluded because the starting points of the inferior buccal branch and mandibular marginal branch were in front of the posterior border of mandibular ramus. The distance from the intersection of the posterior border of mandibular ramus and the plane of angulus oris to the intersection of inferior buccal branch and the plane of angulus oris was (14.96 ± 8.55) mm. Conclusions In most cases studied, the plane of angulus oris is between the inferior buccal branch and mandibular marginal branch in the vicinity of the posterior border of mandibular ramus. Along the plane of angulus oris, within 1.0 cm anterior to the posterior border of mandibular ramus, it is a relatively safe place for surgical approach.
    • 曾朝强; 王晶; 张福洲; 彭新皓; 聂麟
    • 摘要: 目的 总结下颌骨骨折的曲面断层摄影与CT影像学特点并探讨漏诊原因.方法 回顾对比分析43例同时有曲面断层摄影及CT检查的下颌骨骨折影像资料,比较检出率,分析漏诊因素.结果 经MSCT确诊43例共有71处下颌骨骨折及6处颞颌关节脱位,其中,体部骨折16处,颏部骨折21处,髁突骨折14处,角部骨折12处,牙槽骨折4处,升部骨折2处,冠突骨折2处.曲面断层摄影明确骨折63处;可疑骨折6处;漏诊骨折3处,其中髁突颈骨折1处,冠突骨折1处,升部骨折1处;漏诊颞颌关节脱位1处.曲面断层片的骨折诊断检出率为89%,脱位诊断检出率为83%.结论 螺旋CT骨折检出率高于曲面断层摄影.螺旋CT检查结合多平面重建(MPR)、表面遮盖显示(SSD)可更好地显示骨折及其周围情况,术前正确诊断对治疗方案、手术入路及制定详细的手术计划可提供正确指导.
    • 严颖彬; 穆洁; 张兰成; 刘浩; 王志兴; 张军; 沈军; 张萍
    • 摘要: Objective To investigate the effect of surgical treatment of adult mandibular condylar fractures (including intracapsular fracture). Methods Thirty-two patients (33 sides) with condylar fractures underwent open reduction and rigid fixation. Six patients with intracapsular condylar fractures were treated with two 18-mm positional screws through a preauricular approach. Six patients (7 sides) with condylar neck fractures were rigidly fixed by 1 mini-plate via a retromandibular transparotid approach. Twenty patients with subcondylar fractures were operated and fixed by two titanium plates using an angular approach. Results The mean follow-up period was 13.5 months, and the mean maximum mouth opening was 37.5 mm by the last visit. All patients acquired good occlusal relationship and mandibular symmetry. Seven patients (21.9%) experienced transient palsy of the branches of the facial nerve, and recovered completely after three months. One patient developed a salivary fistula, and healed after two weeks of gauze compression. No permanent deficit of any facial nerve branch was observed. No patient showed condylar head resorption. Conclusion Appropriate surgical approaches and fixation methods for different types of condylar fractures are the key factors to achieve reliable clinical results.%目的:探讨包括囊内骨折在内的成人下颌骨髁突骨折的手术疗效。方法32例33侧髁突骨折中,囊内骨折6例,采用耳前入路和2枚18 mm的长螺钉固定;髁颈骨折6例7侧,采用颌后穿腮腺入路及1块小型板固定;髁颈下骨折20例,采用环下颌角入路和2块接骨板固定。结果术后平均随访13.5个月,随访期末平均最大张口度37.5 mm。32例患者均获得良好的咬合关系和面部对称性。7例(21.9%)出现暂时性面神经瘫痪,术后3个月均完全恢复,1例出现涎漏,加压包扎后痊愈。无永久性面瘫、髁头吸收等严重并发症。结论对不同类型的髁突骨折采用适宜的手术入路和内固定方法是取得良好手术效果的关键。
    • 李富强
    • 摘要: 目的:探讨颌间牵引在下颌骨粉碎性骨折坚强内固定手术中的应用。方法:回顾性研究我科共收治下颌骨粉碎性骨折254例,总结治疗方法。结果:本组254例下颌骨多发性粉碎性骨折病例术后均为一期愈合,张口度恢复较好,骨折愈合良好,内固定钛板及钛钉无松脱、无折断。结论:下颌骨多发性、粉碎性骨折病例均采用开放复位坚强内固定手术治疗,效果显著。
    • 李燕波; 何志良; 王承阳; 贺成功; 曹雷; 苏丹妮
    • 摘要: [Objective] To explore the effects of new bone formation of pterygoid muscle in condyle fracture .[Meth‐ods] A total of 8 healthy sheep were randomly divided into observation and control groups ( n=4 each) .Condylar osteot‐omy was used for mimicking mandibular condyle sagittal fracture .Pterygoid muscle function was retained for observation group and blocked for control group .At Weeks 4 ,12 and 24 ,the changes of new bone trabecular number ,thickness ,gap width and bone volume fraction were recorded .Reverse transcription‐polymerase chain reaction (RT‐PCR) and immuno‐histochemistry were used for detecting the changes of osteocalcin (OCN) ,transforming growth factor‐β1 (TGF‐β1) gene and protein .[Results]With elapsing time ,trabecular number ,thickness and bone volume fraction increased significantly while trabecular gap width significantly decreased in observation group as compared to control group ( P0 .05) .In observation group ,the expressions of OCN mRNA and TGF‐β1 mRNA and positive cell percentage increased significantly ( P <0 .05) .As compared with control group ,the expressions of OCN mRNA and TGF‐β1 mRNA and positive cell percentage were significantly higher in observation group during each period ( P<0 .05) .In control group ,the expressions of OCN mRNA and TGF‐β1 mRNA and positive cell percentage peaked during Week 12 and then decreased significantly ( P <0 .05) .[Conclusion] Pterygoid muscle affects remodeling of condyle shape in healing of sagittal condylar fracture .And the mechanism may be due to a formation of new bone and an aggravation of condyle deformity resulting in joint disk or articular fossa adhesion and ankylosis .%【目的】探讨翼外肌在髁突矢状骨折愈合中对新骨形成的影响。【方法】10只健康绵羊随机分为观察组(5只)和对照组(5只),两组绵羊均通过髁突截骨术造成髁突矢状骨折,观察组保留翼外肌功能,对照组阻断翼外肌功能。观察两组绵羊术后4周、12周、24周新生骨骨小梁数量、厚度、间隙宽度及骨体积分数的变化,并采用RT‐PCR和免疫组织化学方法检测骨钙蛋白(osteocalcin ,OCN )、转化生长因子β1(transforming grow th factor‐β1,TGF‐β1)基因及蛋白水平。【结果】随着时间的延长,观察组骨小梁数量、厚度、骨体积分数显著上升,骨小梁间隙宽度显著降低( P <0.05);观察组骨小梁数量、厚度、骨体积分数显著高于同时段对照组,骨小梁间隙宽度显著低于对照组(P <0.05);对照组各时段骨小梁数量、厚度、间隙宽度、骨体积分数比较差异无统计学意义(P >0.05)。观察组OCN mRNA、TGF‐β1 mRNA表达量及阳性细胞百分比随时间延长持续升高( P <0.05);观察组各时段OCN mRNA、TGF‐β1 mRNA表达量及阳性细胞百分比均显著高于对照组( P <0.05);而对照组OCN mRNA、TGF‐β1 mRNA表达及阳性细胞百分比术后12周达峰值,24周陡然降低( P <0.05)。【结论】翼外肌对髁突矢状骨折愈合过程中髁突形态的改建有一定影响,其机制可能是通过促进断面新骨的形成诱发或加重髁突畸形,导致关节盘或关节窝粘连,进而诱发颞下颌关节强直。
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