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采用单块微型钢板治疗且术后未行颌间固定的下颌角骨折:50例患者的回顾性评估

Mandibular angle fractures treated with a single miniplate without postoperative maxillomandibular fixation: A retrospective evaluation of 50 patients.

作者信息

Ribeiro-Junior Paulo Domingos, Vago Thessio Miná, da Silva William Saranholi, Padovan Luis Eduardo Marques, Tiossi Rodrigo

机构信息

a Department of Oral and Maxillofacial Surgery , Sacred Heart University , Bauru , SP , Brazil.

b Department of Restorative Dentistry , School of Dentistry, State University of Londrina , Londrina , PR , Brazil.

出版信息

Cranio. 2018 Jul;36(4):234-242. doi: 10.1080/08869634.2017.1330799. Epub 2017 May 29.

Abstract

OBJECTIVE

This retrospective study evaluated the use of a single miniplate for the treatment of mandibular angle fractures (MAF).

METHODS

Fifty patients with 53 MAF were treated by open reduction and internal fixation with the use of a single miniplate and were analyzed in this study.

RESULTS

Five patients with MAF had postoperative complications that required additional procedures. Three patients had postoperative infection, one patient complained of malocclusion in the first postoperative week, and one patient had miniplate exposure three months after surgery. Every additional procedure was performed in the office under local anesthesia without disruption of the initial fracture treatment. Postoperative maxillomandibular fixation (MMF) was performed in four patients. Treatment of MAF using a single miniplate was effective, with low morbidity and with low rates of postoperative complications. MAF can be treated without MMF, and stability is improved when long miniplates are used.

CONCLUSIONS

The use of a single miniplate is therefore encouraged. However, postoperative MMF should be considered with the presence of little contact between bone segments, malocclusion, or extensive tooth loss.

摘要

目的

本回顾性研究评估使用单个微型钢板治疗下颌角骨折(MAF)的效果。

方法

本研究分析了50例患有53处下颌角骨折的患者,这些患者均采用单个微型钢板进行切开复位内固定治疗。

结果

5例下颌角骨折患者术后出现并发症,需要额外的治疗措施。3例患者发生术后感染,1例患者在术后第一周出现咬合不正,1例患者在术后三个月出现微型钢板外露。每项额外的治疗均在局部麻醉下在诊室进行,未干扰初始骨折治疗。4例患者进行了术后颌间固定(MMF)。使用单个微型钢板治疗下颌角骨折有效,发病率低,术后并发症发生率也低。下颌角骨折无需颌间固定即可治疗,使用长微型钢板时稳定性会提高。

结论

因此,鼓励使用单个微型钢板。然而,当骨段间接触少、存在咬合不正或广泛牙齿缺失时,应考虑术后颌间固定。

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