中国口腔颌面外科杂志

中国口腔颌面外科杂志 ›› 2017, Vol. 15 ›› Issue (6): 534-537.doi: 10.19438/j.cjoms.2017.06.002

• 论著 • 上一篇    下一篇

2种医用锚固钉植入下颌骨髁突中的拉力比较

孙守福1*, 甄锦泽2*, 张善勇, 刘秀明, 郑吉驷2, 徐伟峰2, 沈佩2, 李慧萍2, 郭克2, 钟晓琪2   

  1. 1.上海市同仁医院,上海交通大学医学院附属同仁医院 口腔科,上海 200336;
    2.上海交通大学医学院附属第九人民医院·口腔医学院 口腔外科, 上海市口腔医学重点实验室,上海 200011;
  • 收稿日期:2016-09-07 修回日期:2016-11-16 出版日期:2017-11-20 发布日期:2017-12-21
  • 通讯作者: 张善勇,E-mail: zhangshanyong@126.com;刘秀明,E-mail: sniperr@126.com。#共同通信作者
  • 作者简介:孙守福（1990-）,男,硕士,住院医师,E-mail:sunshoufu@163.com;甄锦泽（1990-）,男,硕士,住院医师,E-mail:zhenlich@163.com。*并列第一作者
  • 基金资助:
    国家自然科学基金（81371168）; 上海交通大学医工交叉项目（YG2013MS63）; 上海市教育委员会高峰-高原学科-上海交通大学医学院“研究型医师”（20152226）; 上海交通大学医学院转化医学创新基金（15ZH2007）; 上海市科学技术委员会生物医药支撑项目（16441908800）; 上海市卫生和计划生育委员会重点项目（201640001）; 科技部国家重点研发计划项目（2016YFC1100600 ）

Comparison of the pullout force of two kinds medical anchoring nails implanted in the condyle

SUN Shou-fu1, ZHEN Jin-ze2, ZHANG Shan-yong2, LIU Xiu-ming2, ZHENG Ji-si2, XU Wei-feng2, SHEN Pei2, LI Hui-ping2, GUO Ke2, ZHONG Xiao-qi2   

  1. 1.Department of Stomatology, Tongren Hospital, Shanghai Jiao Tong University School of Medicine. Shanghai 200336;
    2.Department of Oral Surgery, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine; Shanghai Key Laboratory of Stomatology. Shanghai 200011, China
  • Received:2016-09-07 Revised:2016-11-16 Online:2017-11-20 Published:2017-12-21

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摘要： 目的 比较颞下颌关节盘开放性锚固术中,下颌骨髁突后斜面下缘植入2种锚固钉（传统锚固钉和改良锚固钉）的拉出力量和形式。方法 收集因颞下颌关节病需行颞下颌关节置换的患者术中截下的髁突共10例,分别用传统及改良锚固钉带3-0锚固线、改良锚固钉带2-0锚固线后植入髁突后斜面下缘骨皮质内,各20组,用拉力测试仪进行拉力试验,测试实验中髁突骨皮质受损、锚固钉断裂或松动、锚固线断裂等情况。采用SPSS 17.0软件包对锚固线断裂拉力进行统计学分析。结果 2种医用锚固钉在植入髁突和拉力测试过程中,除锚固线断裂外,均未出现骨皮质受损、锚固钉断裂、松动情况;传统锚固钉带3-0锚固线承受的最大拉力均值为（27.53±5.47）N,改良锚固钉带3-0锚固线承受的最大拉力均值为（25.89±2.64）N,改良锚固钉带2-0锚固线承受的最大拉力均值>50 N。传统型和改良锚固钉（3-0锚固线）2组比较,差异显著（P<0.05）;传统锚固钉（3-0锚固线）与改良锚固钉（2-0锚固线）比较,也具有显著差异（P<0.01）。结论 传统和改良医用锚固钉均可成功植入下颌骨髁突中,且不会导致锚固钉断裂、髁突骨皮质受损;改良锚固钉更加符合髁突解剖外形,更安全舒适,固定的2-0锚固线能承受更大拉力,比传统锚固钉更具有优势。

关键词: 开放性锚固术, 下颌骨髁突, 锚固钉, 锚固线, 拉力分析

Abstract: PURPOSE: To compare and analyze the pullout force and form of the traditional anchoring nail and modified anchoring nail, which were placed in the inferior border of mandibular condyle during open surgery of TMJ anchorage. METHODS: Ten resected condyles were obtained from patients with TMJ replacement due to TMJ osteoarthrosis. Traditional and modified anchoring nails with 3-0 anchoring lines, modified anchoring nail with 2-0 anchor line were implanted respectively in the cortical bone of the inferior border of mandibular condyle. Each group contained 20 nails and was tested by tensile tester to observe the cortical bone damage, anchor nail breakage or loosening and line fracture. The data were analyzed with SPSS17.0 software package. RESULTS: During the two kinds of medical anchoring nail implantation and tensile test, bone cortex damage, anchoring nail fracture and loosening did not occur, except line fracture. Maximum tensile force of traditional nails with 3-0 anchoring lines, modified anchoring nails with 3-0 anchoring lines and modified anchoring nails with 2-0 anchoring lines was (27.53±5.47) N, (25.89±2.64) N and >50 N, respectively. There was significant difference between traditional and modified anchoring nail with 3-0 anchoring line (P<0.05), there was also significant difference between traditional anchoring nail with 3-0 anchoring line and modified anchoring nail with 2-0 anchoring line. CONCLUSIONS: Both conventional and modified medical anchoring nails can be successfully implanted into the condylar neck without nail fractures and damaging the condylar neck cortical bone. The modified anchoring nails are more competent in adapting the condyle anatomical shape, and proven to be safer and more comfortable. Furthermore, the 2-0 anchored line can withhold a higher pull force than the conventional anchoring nails.

Key words: Type 2 diabetes mellitus, Blood glucose control, Dental implant, Stability, Inflammation

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