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[一种用于上颌骨横向牵张成骨的可调式牵张器]

[An adjustable distractor for transverse maxillary distraction osteogenesis].

作者信息

Leyder P, Wycisk G, Quilichini J

机构信息

Chirurgie maxillo-faciale et stomatologie, service de chirurgie plastique, reconstructrice et esthétique, centre hospitalier Robert-Ballanger, boulevard Robert-Ballanger, 93602 Aulnay-sous-Bois cedex, France.

出版信息

Rev Stomatol Chir Maxillofac Chir Orale. 2013 Jun;114(3):170-4. doi: 10.1016/j.revsto.2013.03.014. Epub 2013 May 14.

Abstract

INTRODUCTION

The posterior skeletal widening in conventional distractions (Surgical Assisted Rapid Maxillary Expansion) is often modest, in contrast with a predominant anterior expansion. Until recently, it was not possible to consider transverse palatal distraction osteogenesis and Le Fort I impaction or advancement in the same procedure, as the osteosynthesis plates impeded maxillary anterior opening. We developed new sliding osteosynthesis plates allowing to perform an advancement or impaction Le Fort I osteotomy associated with a low-resistance bipartite palatal distraction osteogenesis. We had for aim to describe the device and to determine its clinical applications.

MATERIAL

This new palatal distractor is made up of two independent stainless steel jacks allowing for an adjustable distraction in the anterior or posterior area as needed. Bone-borne and tooth-borne versions are available.

DISCUSSION

This new distractor can be adjusted sagittally. The distraction can be angular or parallel, and the distraction mode can be modified during post-operative distraction. This device should be adapted to all clinical presentations. It can be used in combination with sliding osteosynthesis to perform a Le Fort 1 osteotomy and at the same time a complete correction of vertical, horizontal, and sagittal deficiencies.

摘要

引言

与主要的前部扩展相比,传统牵张成骨术(手术辅助快速上颌扩展)中后部骨骼的扩展通常较为有限。直到最近,由于接骨板阻碍上颌前部开口,无法在同一手术中同时进行横向腭部牵张成骨术和Le Fort I型截骨术及推进术。我们开发了新型滑动接骨板,能够在进行低阻力二分法腭部牵张成骨术的同时施行Le Fort I型截骨推进或撞击术。我们旨在描述该装置并确定其临床应用。

材料

这种新型腭部牵张器由两个独立的不锈钢千斤顶组成,可根据需要在前部或后部区域进行可调节的牵张。有骨支持型和牙支持型两种版本。

讨论

这种新型牵张器可在矢状面上进行调整。牵张可以是成角的或平行的,并且在术后牵张过程中可以改变牵张模式。该装置应适用于所有临床表现。它可与滑动接骨术联合使用,以施行Le Fort I型截骨术,同时完全矫正垂直、水平和矢状面的不足。

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