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目的比较颌间固位钉和牙弓夹板两种牵引方法在颌骨骨折牵引固定中的临床疗效。方法把48例有咬合紊乱症状的颌骨骨折患者随机分成2组,每组24人,研究组用颌间固位钉植入上下颌骨,对照组用牙弓夹板结扎固定在上下牙列上,2组均采用弹力皮圈在术中牵引辅助复位或在术后牵引调整咬合关系,所有患者均接受了骨折切开复位及小型钛板+螺纹钉固定骨折。检查并记录2组的平均操作时间,术后咬合关系的恢复程度,牙周损害程度,口腔卫生状况,询问患者主观感受,给予统计学分析,得出结论并进行临床疗效判定。结果研究组平均操作时间明显短于对照组;研究组患者的牙周损害程度明显轻于对照组;研究组患者的口腔卫生状况也明显好于对照组;颌间固位钉牵引复位大大减少了患者的副损害和痛苦;从主观舒适度方面,患者更能接受颌间固位钉牵引复位法;在牙列基本完整的前提下,两者在咬合关系的恢复方面无明显差异。结论颌间固位钉较牙弓夹板牵引复位或辅助治疗颌骨骨折是一种快速、简单且有效的方法,值得临床推广使用。
Objective To compare the clinical effects of two kinds of traction methods, including intermaxillary fixation nail and dental arch splint, in the traction and fixation of jaw fracture. Methods Forty-eight patients with mandibular fracture with occlusion disorder were randomly divided into two groups (24 in each group). The study group was implanted into the maxilla and mandible with intermaxillary fixation and the control group was ligated with the dental arch , 2 groups were using stretch leather apron in the surgery to assist the reduction or distraction after surgery to adjust the occlusion relationship, all patients underwent open reduction and reduction of titanium plate and screw fixation of small fractures. The average operation time, recovery degree of occlusal relationship, degree of periodontal injury, oral health status, subjective feelings of patients were inspected and recorded. The statistical analysis was given and the conclusion was drawn and the clinical efficacy was evaluated. Results The average operation time of the study group was significantly shorter than that of the control group. The degree of periodontal damage in the study group was significantly lower than that of the control group. The oral hygiene status of the study group was also significantly better than that of the control group. The intermaxillary fixation nail traction reduction was significantly reduced Patient’s side damage and pain. From the subjective comfort level, the patients were more able to accept the intermaxillary fixation nail traction reduction method. There was no significant difference between the two groups in the recovery of the occlusal relationship under the premise of basically complete dentition. Conclusion The intermaxillary fixation nail is a quick, simple and effective method for the reduction of mandibular fractures compared with traction reduction of dental arch splint and is worthy of clinical promotion.