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中华口腔医学研究杂志(电子版) ›› 2008, Vol. 02 ›› Issue (02) : 152 -158. doi: 10.3877/cma.j.issn.1674-1366.2008-02-009

临床研究

上下颌同步牵张成骨治疗半侧颜面萎缩畸形
曾融生1,(), 王成1, 王剑宁1, 朱双林1   
  1. 1. 510055 广州,中山大学光华口腔医学院·附属口腔医院·口腔医学研究所
  • 收稿日期:2008-01-18 出版日期:2008-04-01
  • 通信作者: 曾融生

Correction of hemifacial atrophy by maxillomandibular distraction osteogenesis in atrophy side

Rong-sheng ZENG1,(), Cheng WANG1, Jian-ning WANG1, Shuang-lin ZHU1   

  1. 1. Guanghua School of Stomatology,Institute of Stomatological Research, Sun Yat-sen University, Guangzhou 510055,China
  • Received:2008-01-18 Published:2008-04-01
  • Corresponding author: Rong-sheng ZENG
引用本文:

曾融生, 王成, 王剑宁, 朱双林. 上下颌同步牵张成骨治疗半侧颜面萎缩畸形[J/OL]. 中华口腔医学研究杂志(电子版), 2008, 02(02): 152-158.

Rong-sheng ZENG, Cheng WANG, Jian-ning WANG, Shuang-lin ZHU. Correction of hemifacial atrophy by maxillomandibular distraction osteogenesis in atrophy side[J/OL]. Chinese Journal of Stomatological Research(Electronic Edition), 2008, 02(02): 152-158.

目的

探讨上下颌骨同步牵张成骨矫正半侧颜面萎缩畸形的临床效果。

方法

半侧颜面萎缩患者3 例,男2 例,女1 例,年龄14 ~19 岁。临床及X 线检查见一侧上下颌骨明显萎缩伴同侧软组织萎缩,平面严重偏斜。患者萎缩侧上下颌骨同期行牵张器植入术并同步牵张成骨,于牵张成骨结束后6 ~8 个月行背阔肌瓣软组织充填术。

结果

萎缩侧上下颌骨平均牵张20 mm。 颜面软硬组织得到明显改善,面颊部丰满,平面矫正,咬合关系良好。 随访1 ~4 年,患侧新骨和软组织无明显吸收,面部基本对称。

结论

矫正半侧颜面萎缩时,同侧上下颌骨同步牵张成骨是延长萎缩的上下颌骨,改善平面并为软组织充填提供支撑的有效治疗方法。

Objective

To investigate the effect of treating hemifacial atrophy and correcting oblique occlusion plane by simultaneous distraction osteogenesis of maxilla and mandibule in atrophy side.

Methods

Three patients (Male:2 Female:1) with hemifacial atrophy were involved. Clinical and X-ray examination showed sever atrophy of bone and soft tissues in one side of face, with seriously oblique occlusion plane. Distractors were embodied into atrophic maxilla and mandible respectively and distraction osteogenesis were performed simultaneously. The latissimus myofacial flaps were used to correct soft tissue 6 ~ 8 months after distraction osteogenesis finished.

Results

Both maxilla and mandible were lengthened 20 mm averagely in atrophic side and the deformities of both bony and soft tissue were improved evidently and occlusion relationship was established well. Following up ranged from 1 to 4 years, patients demonstrated symmetric faces without regenerated bones and soft tissue absorbed.Satisfactory facial contour and profile were achieved.

Conclusions

Simultaneous distraction osteogenesis of maxilla and mandible in atrophic side is an effective method to lengthen atrophic jaws, correct the oblique occlusion plane and improve the result of soft tissue fillings.

图1 术前正位
图2 术前侧位
图3 术前平面偏斜
图4 术前正位三维CT
图5 术前左侧位三维CT
图6 术前右侧位三维CT
图7 术前仰头位三维CT
图8 同侧上下颌安置牵张器X 线正位片
图9 同侧上下颌安置牵张器X 线侧位片
图10 牵张成骨曲面断层片
图11 上颌同期牵张成骨
图12 下颌同期牵张成骨
图13 牵张成骨术后平面
图14 制备背阔肌组织瓣
图15 显露胸背动、静脉蒂
图16 背阔肌组织瓣移植术后6 个月正面图
图17 背阔肌组织瓣移植术后6 个月侧面图
图18 平面矫正,咬合关系良好
图19 术后1 年行红唇畸形二期整复
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