Konaş Ersoy, Tunçbilek Gökhan, Kayikçioğlu Aycan, Akcan Cenk Ahmet, Kocadereli Ilken, Mavili Mehmet Emin
Department of Plastic Reconstructive and Aesthetic Surgery, Hacettepe University Medical School, Samanpazari, Ankara, Turkey.
J Craniofac Surg. 2011 Jul;22(4):1471-5. doi: 10.1097/SCS.0b013e31821d193b.
The aim of the study was to obtain anatomic bone healing and restoration of the patient's premorbid occlusion in complex facial fractures or comminuted facial fracture. Ten patients who applied to a tertiary health care clinic with complex or comminuted fractures, and mandibular fractures combined with condylar fractures which may impair the occlusal harmony were included in the study.After the preparation of premorbid occlusal splints and direct bonded orthodontic brackets, splint-assisted reduction and internal fixation have been performed. The treatment protocol was completed with 4 to 6 weeks of intermaxillary fixation over the splint. All fracture lines showed complete bone healing, without major complications requiring further treatment. Complications included a minor degree of malocclusion in one of the panfacial fracture patients and slight avascular resorption of the condyle in one of the avulsive open comminuted mandibular fracture patients.Using orthodontic splints and direct bonded brackets to obtain and maintain delicate reduction is an efficacious method for the prevention of occlusal disharmony and aesthetic impairments in comminuted lower facial unit and complicated facial fracture patients.
本研究的目的是在复杂面部骨折或粉碎性面部骨折中实现解剖学骨愈合并恢复患者病前的咬合关系。本研究纳入了10例因复杂骨折或粉碎性骨折以及可能损害咬合协调性的下颌骨折合并髁突骨折而就诊于三级医疗诊所的患者。在制作病前咬合夹板和直接粘结正畸托槽后，进行了夹板辅助复位和内固定。治疗方案通过在夹板上进行4至6周的颌间固定而完成。所有骨折线均显示完全骨愈合，无需要进一步治疗的重大并发症。并发症包括1例全面部骨折患者出现轻度错牙合，1例撕脱性开放性粉碎性下颌骨折患者的髁突出现轻微无血管性吸收。使用正畸夹板和直接粘结托槽来获得并维持精细复位是预防粉碎性面下部单元和复杂面部骨折患者咬合不协调及美观受损的有效方法。
