Broyles Justin Michael, Wallner Christoph, Borsuk Daniel E, Dorafshar Amir H
From the Department of Plastic and Reconstructive Surgery, The Johns Hopkins Hospital, Baltimore, MD.
J Craniofac Surg. 2013;24(5):1835-8. doi: 10.1097/SCS.0b013e3182997f50.
Mandibular trauma is a common problem encountered by the craniofacial surgeon. Fractures in the edentulous mandible represent only 3% of these injuries, and optimal management is controversial. This problem is further compounded by malunion and malocclusion when fracture lines heal in incorrect positions. Even with recent advances in imaging and hardware systems, they remain difficult problems that often require multiple operations to obtain satisfactory results. We present a 69-year-old man with an edentulous mandibular fracture and concomitant malocclusion after a series of unsuccessful operations. By using computer-assisted design and manufacturing technology, we were able to plan osteotomies for correct anatomic positioning, which restored dental occlusion and facial aesthetics. A follow-up at 6 months postoperatively revealed a stable and anatomic reconstruction.
下颌骨创伤是颅面外科医生常见的问题。无牙下颌骨骨折仅占这些损伤的3%，最佳治疗方法存在争议。当骨折线在不正确的位置愈合时，骨不连和咬合不正会使这个问题更加复杂。即使有了影像学和硬件系统的最新进展，这些问题仍然很棘手，往往需要多次手术才能获得满意的结果。我们介绍了一名69岁的男性，他患有无牙下颌骨骨折，并在一系列手术失败后伴有咬合不正。通过使用计算机辅助设计和制造技术，我们能够规划截骨术以实现正确的解剖定位，从而恢复牙列咬合和面部美观。术后6个月的随访显示重建稳定且符合解剖结构。
