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下颌角骨折伴第三磨牙且第三磨牙与骨折线相关时,手术治疗后常规取出接骨板。

Routine removal of the plate after surgical treatment for mandibular angle fracture with a third molar in relation to the fracture line.

作者信息

Yamamoto Kazuhiko, Matsusue Yumiko, Horita Satoshi, Murakami Kazuhiro, Sugiura Tsutomu, Kirita Tadaaki

机构信息

Department of Oral and Maxillofacial Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan.

出版信息

Ann Maxillofac Surg. 2015 Jan-Jun;5(1):77-81. doi: 10.4103/2231-0746.161077.

Abstract

PURPOSE

The purpose was to analyze the clinical course of surgically treated mandibular angle fractures from the viewpoint of routine removal of the plate because these fractures are associated with high rates of complications and plate removal.

SUBJECTS AND METHODS

The subjects were 40 patients with unilateral mandibular angle fracture, which was intraorally reduced and principally fixed with a single miniplate on the external oblique ridge. The third molar in relation to the fracture line was extracted in seven patients during the surgery. Clinical course was evaluated in terms of removal of the plate, preservation of the third molar and complications.

RESULTS

One patient showed a wound infection postoperatively, and two patients developed pericoronitis during the follow-up. These were managed with medication and local irrigation. One patient with a preserved third molar did not make a required visit and was lost from the follow-up. Removal of the plates was performed in 39 patients after confirmation of good fracture healing, mostly within a year. Twenty-four of 32 preserved third molars were simultaneously extracted. These procedures were generally performed under local anesthesia on an outpatient basis, and they did not cause any complications.

CONCLUSIONS

Routine removal of the plate after surgical treatment for mandibular angle fractures, simultaneously with extraction of the third molar if indicated, may be beneficial to avoid complications related to the plate and the third molar later in life.

摘要

目的

由于下颌角骨折并发症发生率高且需取出钢板,本研究旨在从常规取出钢板的角度分析手术治疗下颌角骨折的临床过程。

对象与方法

研究对象为40例单侧下颌角骨折患者,骨折经口内复位,主要在颊外斜线处用单块微型钢板固定。7例患者在手术过程中拔除了与骨折线相关的第三磨牙。从钢板取出情况、第三磨牙保留情况及并发症方面评估临床过程。

结果

1例患者术后出现伤口感染,2例患者在随访期间发生冠周炎,经药物治疗及局部冲洗处理。1例保留第三磨牙的患者未按要求复诊,失访。39例患者在确认骨折愈合良好后取出钢板,大多在1年内。32颗保留的第三磨牙中有24颗同时拔除。这些操作一般在门诊局部麻醉下进行,未引起任何并发症。

结论

下颌角骨折手术治疗后常规取出钢板,如有指征同时拔除第三磨牙,可能有助于避免后期与钢板及第三磨牙相关的并发症。

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