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三维锁定钢板与传统微型钢板治疗下颌前部骨折

Three-dimensional Locking Plate and Conventional Miniplates in the Treatment of Mandibular Anterior Fractures.

作者信息

Budhraja Nilima J, Shenoi Ramakrishna S, Badjate Samprati J, Bang Kshitij O, Ingole Pranav D, Kolte Vrinda S

机构信息

Department of Oral and Maxillofacial Surgery, VSPM's Dental College and Research Center, Nagpur, Maharashtra, India.

出版信息

Ann Maxillofac Surg. 2018 Jan-Jun;8(1):73-77. doi: 10.4103/ams.ams_175_17.

Abstract

CONTEXT

Three-dimensional (3D) locking plates has been designed with the hypothesis that this will overcome the disadvantages of both the systems and also advantages of both systems will be combined for the management of mandibular fractures.

AIMS

The purpose of this study was to evaluate the efficacy of 2-mm 3D locking miniplate in the management of anterior mandibular fracture and to compare it with Champy's miniplate.

SETTINGS AND DESIGN

A prospective, randomized, clinical trial was carried out in thirty patients who were divided equally in two groups.

SUBJECTS AND METHODS

Group I and Group II patients were treated with 2-mm 3D locking plates and 2-mm standard miniplates, respectively. They were evaluated according to the outcomes of the study, that is, working time, wound dehiscence, infection, segmental mobility, postoperative occlusion, need for postoperative intermaxillary fixation (IMF), and radiological evaluation of reduction and fixation.

STATISTICAL ANALYSIS USED

Student's -test and Mann-Whitney test were used to compare the two systems. The data were analyzed using Statistical Package for the Social Science version 14.0. The value was taken as significant when <0.05 (confidence interval of 95% was taken).

RESULTS

The mean duration of procedure for Group I was found to be 49.33 min, whereas for Group II was 59.67 min. There was significantly greater pain on day 1 and at 1 week in Group II patients. 6.7% ( = 1) of both groups showed incidence of infection. Postoperative stability was adequate in most cases except in one patient ( = 1) of 3D locking system, which was revealed as postoperative occlusal disharmony, unsatisfactory radiological reduction of the fracture fragments, and the segmental mobility. There was no incidence of wound dehiscence, tooth damage, and nerve damage in either group.

CONCLUSIONS

The result of the study can conclude that there is no major difference between both systems in terms of treatment outcome.

摘要

背景

三维(3D)锁定钢板的设计基于这样一种假设,即它将克服两种系统的缺点,并且两种系统的优点将结合起来用于下颌骨骨折的治疗。

目的

本研究的目的是评估2毫米3D锁定微型钢板在下颌骨前部骨折治疗中的疗效,并将其与尚皮微型钢板进行比较。

设置与设计

对30例患者进行了一项前瞻性、随机临床试验,这些患者被平均分为两组。

研究对象与方法

第一组和第二组患者分别用2毫米3D锁定钢板和2毫米标准微型钢板治疗。根据研究结果对他们进行评估,即手术时间、伤口裂开、感染、节段性活动度、术后咬合、术后颌间固定(IMF)的必要性以及骨折复位和固定的影像学评估。

所用统计分析方法

采用学生t检验和曼-惠特尼检验比较两种系统。使用社会科学统计软件包第14.0版对数据进行分析。当P值<0.05(采用95%置信区间)时,认为差异具有统计学意义。

结果

发现第一组的平均手术时间为49.33分钟,而第二组为59.67分钟。第二组患者在第1天和第1周时疼痛明显更剧烈。两组均有6.7%(n = 1)的患者出现感染。除3D锁定系统的1例患者(n = 1)外,大多数情况下术后稳定性良好,该患者表现为术后咬合不协调、骨折碎片的影像学复位不理想以及节段性活动度。两组均未发生伤口裂开、牙齿损伤和神经损伤。

结论

该研究结果可以得出结论,两种系统在治疗效果方面没有重大差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/21e4/6018293/b4ae60c98831/AMS-8-73-g001.jpg

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