State Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School and Hospital of Stomatology, Wuhan University, Wuhan, People's Republic of China.
Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Wuhan University, Wuhan, People's Republic of China.
J Craniofac Surg. 2024;35(5):e423-e424. doi: 10.1097/SCS.0000000000010100. Epub 2024 Apr 3.
The use of absorbable plates can be challenging for mandibular fractures involving bilateral dentition. Chewing and mouth opening movements may cause loosening or breakage of absorbable materials, leading to displacement of bone segments and resulting in malocclusion. The use of absorbable materials for bilateral mandibular fracture surgery itself raises concerns for surgeons. Timely intermaxillary elastic traction is essential for these patients after surgery to maintain correct occlusion. The surgical approaches were performed with intraoral mandibular sulcus incisions. During the surgery, intermaxillary fixation screws were implanted and steel wires were used for intermaxillary ligation and fixation to restore the occlusal. After the fractured segments were sequentially reduced, they were fixed with inion 2.0 absorbable plates. The patient underwent intermaxillary elastic traction for 1 week. Elastic mask was used to assist in stabilizing the position of the jawbone and maintaining occlusion. After discharge, the patient continued traction at home for 3 weeks before removing the intermaxillary fixation screws. The patient recovered well after surgery without any complications. The postoperative occlusal relationship is good. Postoperative CT showed good reduction of the fractured segments. For the case reported in this article, elastic traction was promptly implemented after surgery. We emphasize that restoring occlusion is always the treatment goal for jawbone fractures. We believe that keeping the intermaxillary fixation screws for a month is a wise choice to be prepared for unexpected needs.
使用可吸收板对于涉及双侧牙齿的下颌骨骨折可能具有挑战性。咀嚼和张口运动可能导致可吸收材料松动或断裂，导致骨段移位，并导致咬合不正。对于双侧下颌骨骨折手术，使用可吸收材料引起了外科医生的关注。对于这些患者，手术后及时进行颌间弹性牵引对于维持正确的咬合至关重要。手术入路采用口腔下颌沟切口。手术过程中，植入颌间固定螺钉，并使用钢丝进行颌间结扎和固定，以恢复咬合。骨折段依次复位后，用 2.0 可吸收板固定。患者接受颌间弹性牵引 1 周。弹性面罩用于辅助稳定颌骨位置并维持咬合。出院后，患者在家中继续牵引 3 周，然后取出颌间固定螺钉。患者术后恢复良好，无任何并发症。术后咬合关系良好。术后 CT 显示骨折段复位良好。对于本文报道的病例，术后及时实施了弹性牵引。我们强调，恢复咬合始终是颌骨骨折的治疗目标。我们认为，保留颌间固定螺钉一个月是明智的选择，可以为意外需求做好准备。
