关键词: 下颌骨髁突, 矢状骨折, 游离再植, 坚固内固定

Abstract:

Objective To summarize the surgical treatment effects of dislocation sagittal fracture of the mandibular condyle （DSFMC）. Methods Twenty- two cases of DSFMC were classified according to the fracture location and treated with surgery. The clinical and radiographic outcomes were contrasted before and after treatment. Results ① There were 18%, 57% and 25% cases of type Ⅰ, type Ⅱ and type Ⅲ DSFMC respectively. ②For type ⅠDSFMC, dislocation part of condyle was removed. For type Ⅱ DSFMC, nine dislocation parts of condyles were free grafting and rigid fixation, and five dislocation parts of condyles were removed. The whole condyle was resected because of ankylosis of TMJ in two cases. For type Ⅲ DSFMC, dislocation part was free grafting and rigid fixation in five condyles. The whole condyle was removed in two cases due to comminuted DSFMC. ③Postoperative mouth opening and mouth opening deviation were 33.9 mm and 1.5 mm respectively 6 months after the surgical treatment. There were significant improvement on mouth opening and mouth opening deviation than those before the surgical treatment（P<0.05）. Normal occluding relation was resumed in 17 cases. With occlusal adjustment, occluding relation was resumed also for those 5 cases that showed 1- 2 mm open bite. ④There was no postoperative evidence of condylar resorption and plate distortion. Conclusion Surgical treatment is an effective way for DSFMC. Mouth opening and mouth opening deviation can be improved significantly after surgical treatment. After surgical treatment, DSFMC can resume normal occlusal relation also. There is no significant condylar resorption after free grafting.

Key words: mandibular condyle, sagittal fracture, free grafting, rigid fixation