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论文摘要

自体喙突移植重建髁突对儿童颞下颌关节强直患者下颌骨生长的远期影响

Long-term effects of autogenous coronoid grafts on the facial growth of children with unilateral temporomandibular joint ankylosis and reconstructed mandibular condyle

作者:阚召俊,苏成利,李运峰

Author:Kan Zhaojun,Su Chengli,Li Yunfeng

收稿日期:2019-05-05          年卷(期)页码:2020,38(1):23-23-29

期刊名称:华西口腔医学杂志

Journal Name:West China Journal of Stomatology

关键字:颞下颌关节,关节强直,儿童,喙突移植,下颌骨生长,

Key words:temporomandibular joint,ankylosis,children,coronoid process,mandible growth,

基金项目:国家自然科学基金青年科学基金(81300858)

中文摘要

目的 儿童期下颌骨髁突受损通常导致错颌畸形和面部生长不协调。本研究目的是评价自体喙突移植重建下颌骨髁突对儿童颞下颌关节强直患者面部生长发育的远期影响。方法 追踪评估2008年1月1日至2016年12月31日期间收治于四川大学华西口腔医院正颌及关节外科的10名单侧颞下颌关节强直的儿童患者,其中包括3名男性和7名女性,于5~12岁期间接受了关节间隙成形术、同侧喙突移植髁突重建术和带蒂颞筋膜瓣置入术。术后追踪3~8年,平均4.9年。术后拍摄曲面断层X线片,测定患侧下颌体长度和下颌支高度的生长量并与健侧相比较。结果 所有患者术后恢复良好,追踪结束时10名患者的最大开口度为32~41 mm,平均35.6 mm。自体喙突移植重建髁突解除强直后下颌支高度和下颌体长度均继续生长,但是依然存在生长不足的现象。与初始数据(术后)相比,患侧下颌支高度(随访结束)增加了25.3%(PPPP结论 自体喙突移植重建下颌骨髁突治疗儿童颞下颌关节强直后,患侧下颌骨可继续生长,但依然会存在生长不足的现象。在颞下颌关节强直治疗完成后,相比于健侧,患侧的生长率是减小的。

英文摘要

ObjectiveMandibular condyle injury usually results in malocclusion and disharmony of facial growth in growing children. This study aimed to evaluate the long-term effects of autogenous coronoid grafts on the facial growth of children with unilateral temporomandibular joint (TMJ) ankylosis who underwent mandibular condyle reconstruction.MethodsTen growing patients with unilateral bony TMJ ankylosis admitted in West China Hospital of Stomatology, Sichuan University between January 1st, 2008 and December 31st, 2016 were followed up and evaluated. These patients include three males and seven females with ages ranging from 5 years to 12 years at the time of surgery. Each patient underwent gap arthroplasty, condyle reconstruction with ipsilateral coronoid, and interposition of the pedicled temporalis fascial flap in a single operation. The postoperative follow-up ranged from 3 years to 8 years with an average of 4.9 years. Postoperative panoramic radiographs determined the growth of the mandibular height and length on the affected side and compared it with those of the healthy side.ResultsAll patients recovered uneventfully after surgery. At the end of follow-up period, the maximal mouth opening ranged from 32 mm to 41 mm with an average of 35.6 mm. Mandibular height and length continued to grow after the successful treatment of ankylosis using autogenous coronoid grafts for condyle reconstruction. However, growth deficit still existed. The final ramus height and mandibular length of the affected side at the end of follow-up increased by 25.3% (PPPConclusionMandibular height and length continued to grow after the successful treatment of ankylosis by using autogenous coronoid grafts for condyle reconstruction. However, growth deficit still existed. The growth rate of the affected mandible was reduced compared with that of the undisturbed side even after treatment of ankylosis.

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