Van Butsele B, Neyt L, Abeloos J, De Clercq C, Mommaerts M, Withofs D, De Backer T, Van Dorpe J, Vanvuchelen J
Dienst mond-, kaak- en aangezichtschirurgie, A.Z. Sint-Jan, Brugge.
Acta Stomatol Belg. 1993 Sep;90(3):189-93.
A case of a median mandibular fracture with extensive osteolysis 8 weeks following a reduction and protrusion genioplasty is reported. A porous hydroxylapatite block, Interpore 200, was used for contour augmentation at the labiomental fold. The weakening effect of the osteotomy, a foreign body-related chronic osteomyelitis, and repetitive angulation of the mandible during mastication play a role in the pathogenesis of this fracture. Treatment consisted of removal of the porous hydroxylapatite block, removal of the screws and plates, surgical debridement of the necrotic tissue, antibiotics, and immobilization with an arch bar on the buccal side and a lingual acrylic splint to prevent rotation of the upper border of the mandible. Healing was uneventful, without loss of teeth.
报告了1例在颏成形术复位并前突8周后发生下颌骨中部骨折伴广泛骨质溶解的病例。使用多孔羟基磷灰石块Interpore 200对唇颏沟进行轮廓增强。截骨术的削弱作用、异物相关的慢性骨髓炎以及咀嚼过程中下颌骨的反复成角在该骨折的发病机制中起作用。治疗包括取出多孔羟基磷灰石块、取出螺钉和钢板、对坏死组织进行手术清创、使用抗生素,以及在颊侧用牙弓夹板和舌侧丙烯酸夹板固定以防止下颌骨上缘旋转。愈合过程顺利,无牙齿脱落。