可吸收内固定材料在正颌外科中的应用
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摘要
可吸收内固定材料具有良好的生物相容性、适宜的生物降解性等优点,在口腔颌面外科领域应用越来越广泛,但目前主要集中在口腔颌面部骨折的内固定治疗中,而在正颌外科领域中应用较少。其原因主要是由于可吸收材料的机械强度不足,难以拮抗加载在颌骨上的各种应力。文章介绍一种在正颌外科手术中上颌骨截骨后骨块间的新型固位方式,即:采用骨块间榫卯结构辅助可吸收板及螺钉进行固定的方法。
The many advantages,such as good biocompatibility and biodegradability,of resorbable materials for internal fixation enable them to be widely used in the field of oral and maxillofacial surgery. However,less papers with relation to the use of resorbable materials were reported in the field of orthognathic surgery for the reason that resorbable materials can′ t resist various stresses loaded on jaws because of deficient mechanical strength. This study introduced a new type of fixation for maxillary segments after osteotomies in the treatment of patients with dento-maxillofacial deformities,that is the mortise and tenon joint structure assisting resorbable materials for fixation.
The many advantages,such as good biocompatibility and biodegradability,of resorbable materials for internal fixation enable them to be widely used in the field of oral and maxillofacial surgery. However,less papers with relation to the use of resorbable materials were reported in the field of orthognathic surgery for the reason that resorbable materials can′ t resist various stresses loaded on jaws because of deficient mechanical strength. This study introduced a new type of fixation for maxillary segments after osteotomies in the treatment of patients with dento-maxillofacial deformities,that is the mortise and tenon joint structure assisting resorbable materials for fixation.
引文
[1]张天嘉,徐昱婷,沈国芳,等.国际正颌外科发展回顾与展望[J].中国口腔颌面外科杂志,2018,16(6):547-552.
[2]Tomomatsu N,Kurohara K,Nakakuki K,et al.Influence of the anatomical form of the posterior maxilla on the reliability of superior maxillary repositioning by Le FortⅠosteotomy[J].Int JOral Maxillofac Surg,2019,48(5):612-619.
[3]Stokbro K,Borg SW,Andersen M?,et al.Patient-specific 3Dprinted plates improve stability of Le Fort 1 osteotomies in vitro[J].J Craniomaxillofac Surg,2019,47(3):394-399.
[4]Ueki K,Yoshizawa K,Moroi A,et al.Evaluation of maxillary sinus after Le FortⅠosteotomy using various fixation materials[J].J Craniomaxillofac Surg,2017,45(4):552-557.
[5]沈国芳,房兵.正颌外科学[M].杭州:浙江科学技术出版社,2012:4.
[6]吴列红,姚伟伟,张美红,等.可吸收内固定材料在颌骨骨折中的临床应用[J].浙江创伤外科,2013,18(6):852-853.
[7]Laine P,Kontio R,Lindqvist C,et al.Are there any complications with bioresorbable fixation devices?A 10-year review in orthognathic surgery[J].Int J Oral Maxillofac Surg,2004,33:240-244.
[8]刘海鹏,赵自然.聚左旋乳酸微型接骨板行颌骨骨折内固定的效果评价[J].吉林大学学报(医学版),2009,35(3):408-409.
[9]langhin RM,Block MS,Wilk R,et al.Resorbable plates for fixation of mandibular fracture:a prospective study[J].J Oral Maxillofac Surg,2007,65(1):89-96.
[10]胡中艳,曹阳.中国古代家具设计的继承与发展[J].包装工程,2009,30(1):158-160.
[11]王茜,张振国.计算机辅助设计在榫卯结构设计中的应用研究[J].机械设计,2013,30(11):122-124.
[12]唐开军.木家具常用榫结构受力分析与计算[J].中南林业科技大学学报,1999,19(3):63-68.
[13]郑家鑫.论古代巢居建筑的发展与传承[J].山西建筑,2015,10:26-27.
[14]李彪,姜腾飞,沈舜尧,等.3D打印个体化钛板在正颌手术中的应用及其准确性评价[J].中国口腔颌面外科杂志,2016,14(5):419-424.
[15]Xia JJ,Gateno J,Teichgraeber JF,et al.Accuracy of the computer-aided surgical simulation(CASS)system in the treatment of patients with complex craniomaxillofacial deformity:a pilot study[J].J Oral Maxillofac Surg,2007,65(2):248-254.
[2]Tomomatsu N,Kurohara K,Nakakuki K,et al.Influence of the anatomical form of the posterior maxilla on the reliability of superior maxillary repositioning by Le FortⅠosteotomy[J].Int JOral Maxillofac Surg,2019,48(5):612-619.
[3]Stokbro K,Borg SW,Andersen M?,et al.Patient-specific 3Dprinted plates improve stability of Le Fort 1 osteotomies in vitro[J].J Craniomaxillofac Surg,2019,47(3):394-399.
[4]Ueki K,Yoshizawa K,Moroi A,et al.Evaluation of maxillary sinus after Le FortⅠosteotomy using various fixation materials[J].J Craniomaxillofac Surg,2017,45(4):552-557.
[5]沈国芳,房兵.正颌外科学[M].杭州:浙江科学技术出版社,2012:4.
[6]吴列红,姚伟伟,张美红,等.可吸收内固定材料在颌骨骨折中的临床应用[J].浙江创伤外科,2013,18(6):852-853.
[7]Laine P,Kontio R,Lindqvist C,et al.Are there any complications with bioresorbable fixation devices?A 10-year review in orthognathic surgery[J].Int J Oral Maxillofac Surg,2004,33:240-244.
[8]刘海鹏,赵自然.聚左旋乳酸微型接骨板行颌骨骨折内固定的效果评价[J].吉林大学学报(医学版),2009,35(3):408-409.
[9]langhin RM,Block MS,Wilk R,et al.Resorbable plates for fixation of mandibular fracture:a prospective study[J].J Oral Maxillofac Surg,2007,65(1):89-96.
[10]胡中艳,曹阳.中国古代家具设计的继承与发展[J].包装工程,2009,30(1):158-160.
[11]王茜,张振国.计算机辅助设计在榫卯结构设计中的应用研究[J].机械设计,2013,30(11):122-124.
[12]唐开军.木家具常用榫结构受力分析与计算[J].中南林业科技大学学报,1999,19(3):63-68.
[13]郑家鑫.论古代巢居建筑的发展与传承[J].山西建筑,2015,10:26-27.
[14]李彪,姜腾飞,沈舜尧,等.3D打印个体化钛板在正颌手术中的应用及其准确性评价[J].中国口腔颌面外科杂志,2016,14(5):419-424.
[15]Xia JJ,Gateno J,Teichgraeber JF,et al.Accuracy of the computer-aided surgical simulation(CASS)system in the treatment of patients with complex craniomaxillofacial deformity:a pilot study[J].J Oral Maxillofac Surg,2007,65(2):248-254.