正畸辅助儿童髁突囊内骨折外脱位伴下颌后缩的闭合性治疗

中国口腔颌面外科杂志 ›› 2015, Vol. 13 ›› Issue (6): 550-553.

正畸辅助儿童髁突囊内骨折外脱位伴下颌后缩的闭合性治疗

唐艳梅，徐兵，聂萍，王晓玲，薛晓晨，朱敏

上海交通大学医学院附属第九人民医院?口腔医学院口腔颅颌面科，上海市口腔医学重点实验室，上海 200011

收稿日期:2014-12-16 出版日期:2015-11-20 发布日期:2015-12-03
通讯作者: 朱敏，E-mail: zminnie@126.com
作者简介:唐艳梅(1990-)，女，七年制硕士研究生，E-mail:tangyanmei7460@163.com

Closed treatment of pediatric dislocated intracapsular condylar fractures with mandibular retrusion using orthodontic appliance

TANG Yan-mei, XU Bin, NIE Ping, WANG Xiao-ling, XUE Xiao-chen, ZHU Min.

Department of Oral and Craniomaxillofacial Science, Shanghai Ninth People’s Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine; Shanghai Key Laboratory of Stomatology. Shanghai 200011, China

Received:2014-12-16 Online:2015-11-20 Published:2015-12-03

摘要/Abstract

摘要： 目的：尝试正畸辅助闭合性治疗儿童髁突囊内骨折外脱位伴颏部骨折及下颌后缩，并观察其短期治疗效果。方法：1例9岁儿童外伤后15 d就诊，临床及影像学检查诊断为颏部骨折，双侧髁突囊内骨折外脱位，伴下牙弓增宽、下颌后缩。取模设计模型外科，制作Herbst矫治器。全麻下手法复位双侧髁突并缩窄下牙弓，同时戴入矫治器前移下颌。结果：配戴1个月后去除矫治器，随访6个月后患者咬合关系正常，下颌运动无碍，锥形束CT（CBCT）显示双侧髁突愈合改建良好，颏部骨折对位愈合。结论：借助Herbst矫治器的辅助，可闭合性治疗儿童髁突骨折外脱位伴颏部骨折及下颌后缩，短期随访获得了良好的咬合关系、髁突形态及下颌功能。

关键词: 儿童, 下颌骨骨折, 髁突骨折, 闭合性治疗, 功能矫治器

Abstract: PURPOSE : To introduce a non-surgical method of treating pediatric dislocated condylar fracture associated with symphyseal fracture and malocclusion. METHODS : A nine-year-old boy was transferred to our hospital 15 days after injury. He was diagnosed as symphyseal fracture with bilateral dislocated condylar fracture, lower arch expansion and mandibular retrusion. Herbst appliance was designed and manufactured. Under general anesthesia, dislocated condyles and expanded dental arch were reduced manipulatively. The Herbst appliance was fitted as well. RESULTS : The Herbst appliance was removed 1 month after wearing. During follow-up period, bilateral fractured condyles healed and remodeled well. Normal occlusal relationship was regained as well as mandibular function. CONCLUTIONS: Herbst appliance was feasible in treating patients with mandibular retrusion resulting from intracapsular condylar fractures.

Key words: Pediatric, Mandibular fracture, Condylar fracture, Closed treatment, Functional appliance

中图分类号:

R782.4

唐艳梅，徐兵，聂萍，王晓玲，薛晓晨，朱敏. 正畸辅助儿童髁突囊内骨折外脱位伴下颌后缩的闭合性治疗[J]. 中国口腔颌面外科杂志, 2015, 13(6): 550-553.

TANG Yan-mei, XU Bin, NIE Ping, WANG Xiao-ling, XUE Xiao-chen, ZHU Min.. Closed treatment of pediatric dislocated intracapsular condylar fractures with mandibular retrusion using orthodontic appliance[J]. China J Oral Maxillofac Surg, 2015, 13(6): 550-553.

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