颌骨骨折内固定术后咬合不良的危险因素分析及预防建议
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摘要
目的分析颌骨骨折内固定术后咬合不良的危险因素,并提出预防建议。方法回顾性分析医院2015年1月至2018年1月收治的101例实施内固定术的颌骨骨折患者的临床资料,根据咬合关系恢复情况将患者分为预后良好组和预后不良组,采用描述性检验和Logistic回归分析法明确咬合不良的危险因素。结果 101例患者中,有20例发生术后咬合不良,发生率为19.80%;单因素分析结果显示,预后不良组年龄>60岁、多处骨折、粉碎性骨折、复位不准确、术后无颌间牵引、术后无颌间固定、术者工龄<3年构成比高于预后良好组(P<0.05);Logistic回归分析结果显示,上述因素均是影响患者术后咬合不良的独立危险因素(P<0.05)。结论年龄>60岁、骨折部位、粉碎性骨折、复位情况、术后颌间牵引、术后颌间固定、术者工龄<3年均是影响颌骨骨折内固定术后咬合不良的独立危险因素,需制定针对性预防措施。
Objective To analyze the risk factors of malocclusion after internal fixation of jaw fractures and to provide preventive suggestions. Methods The clinical data of 101 patients with jaw fractures and implement internal fixation from January 2015 to January 2018 were retrospective analysis. According to the recovery of malocclusion, patients were divided into good prognosis group and bad prognosis group. Descriptive test and Logistic regression analysis were used to identify the risk factors of malocclusion. Results Among 101 patients, 20 cases had malocclusion, and the incidence was 19.80%.The univariate analysis showed that the proportion of age >60, multiple fractures, comminuted fractures, inaccurate reduction, no intermaxillary traction, no intermaxillary fixation and less than 3 years of operator's service in the bad prognosis group were higher than those in the good prognosis group(P<0.05); the Logistic regression analysis showed that the above factors were independent risk factors of malocclusion after operation(P<0.05). Conclusion Age>60, fractures site,comminuted fractures, reposition condition, postoperatively intermaxillary traction, postoperatively intermaxillary fixation,and less than 3 years of operator's service are the independent risk factors of malocclusion after internal fixation of jaw fractures, and targeted preventive measures need to be formulated.
Objective To analyze the risk factors of malocclusion after internal fixation of jaw fractures and to provide preventive suggestions. Methods The clinical data of 101 patients with jaw fractures and implement internal fixation from January 2015 to January 2018 were retrospective analysis. According to the recovery of malocclusion, patients were divided into good prognosis group and bad prognosis group. Descriptive test and Logistic regression analysis were used to identify the risk factors of malocclusion. Results Among 101 patients, 20 cases had malocclusion, and the incidence was 19.80%.The univariate analysis showed that the proportion of age >60, multiple fractures, comminuted fractures, inaccurate reduction, no intermaxillary traction, no intermaxillary fixation and less than 3 years of operator's service in the bad prognosis group were higher than those in the good prognosis group(P<0.05); the Logistic regression analysis showed that the above factors were independent risk factors of malocclusion after operation(P<0.05). Conclusion Age>60, fractures site,comminuted fractures, reposition condition, postoperatively intermaxillary traction, postoperatively intermaxillary fixation,and less than 3 years of operator's service are the independent risk factors of malocclusion after internal fixation of jaw fractures, and targeted preventive measures need to be formulated.
引文
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[10]王晋,王晨齐,武芳珍.颌骨骨折坚强内固定术后咬关系不良的防治[J].中国伤残医学,2015,23(3):106-107.
[2]高志彪,呼海燕,白振西,等.微型钛板联合颌间牵引钉内固定术治疗颌骨骨折疗效观察[J].现代生物医学进展,2016,16(28):5520-5522.
[3]杨茗媚,刘广民,孙斌.颌间牵引钉联合微型钛板内固定修复颌骨骨折患者41例的疗效及近期随访研究[J].中国地方病防治杂志,2016,31(12):1371-1372.
[4]范珍明,张心明.口腔颌面外科学[M].2版.北京:科学出版社,2014:256-258.
[5]张志愿.口腔颌面外科学[M].7版.北京:人民卫生出版社,2012:199-205.
[6]刘睿,段晓峰.颌骨骨折术后恢复咬合关系正畸的必要性[J].全科口腔医学电子杂志,2017,4(11):25.
[7]李坤.面部陈旧性复杂性颌骨骨折中正颌外科技术应用体会[J].中国医疗美容,2016,6(11):68-70.
[8]王岳森,克热木·阿巴司,龚忠诚,等.颌骨骨折治疗失败48例原因分析[J].临床误诊误治,2016,29(3):70-73.
[9]李自强.颌骨骨折治疗后颌间弹性牵引对咬合关系恢复的影响[J].中国保健营养,2017,27(3):165-167.
[10]王晋,王晨齐,武芳珍.颌骨骨折坚强内固定术后咬关系不良的防治[J].中国伤残医学,2015,23(3):106-107.