CAD/CAM应用于健侧下颌角截骨及预成型钛网联合移植整复半侧颜面短小

doi:10.13591/j.cnki.kqyx.2023.01.013

Abstract

Abstract: Objective To explore the indications and clinical effects of simultaneous mandibular angleplasty on the unaffected side, performed using preformed titanium mesh combined with mandibular angle bone graft, for the treatment of hemifacial microsomia (HFM). Methods The study group included 11 patients between 2013 and 2021 with HFM who underwent simultaneous mandibular angle reduction of the unaffected side and augmentation of the affected side using resected bone scaffolds within the titanium mesh. A series of mandibular linear measurements such as ramus height(RH)and mandibular body length(BL), angular measurements, and asymmetry index combined with clinical photographs and postoperative complications were used to assess the therapeutic effect. Results Postoperatively, all patients were satisfied. Significant improvement in mandibular contour was shown, with no obvious complications. Postoperative data, such as BL and angular measurements, showed no statistically significant differences(P>0.05) between the affected and unaffected sides with improvement in symmetry, except for RH(P<0.05). The preoperative and postoperative asymmetry index were (17.11±4.56)% and (4.81±1.73)%, respectively, with significant improvement(P=0.002). Conclusion This approach provides satisfactory results and significantly improves facial asymmetries for unilateral HFM with hypertrophy of the contralateral mandibular angle.

Key words: hemifacial microsomia, bone augmentation, preformed titanium mesh, CAD/CAM, mandibularangle bone graft

CLC Number:

R782.23

SONG Libin,Mohammed Qasem AlWatary,HE Yingyou,BI Dandan,LI Jihua. Correction of hemifacial microsomia using preformed titanium mesh combined with contralateral mandibular angle bone graft with CAD/CAM assistance[J]. Stomatology, 2023, 43(1): 75-81.

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References 26

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患者序号	手术方式	Pruzansky- Kaban分型	年龄/岁	性别	并发症			随访时间/月
患者序号	手术方式	Pruzansky- Kaban分型	年龄/岁	性别	钛网暴露、松动	下牙槽神经损伤	感染	随访时间/月
1	M+G	Ⅰ	21	男	无	无	无	15
2	M+C	ⅡA	23	男	无	暂时	无	13
3	M	Ⅰ	26	女	无	无	无	12
4	M	Ⅰ	29	男	无	无	无	12
5	M	Ⅰ	21	女	无	暂时	无	10
6	M	Ⅰ	20	女	无	暂时	无	18
7	M+R	ⅡA	19	男	无	无	无	11
8	M	ⅡA	26	女	无	无	无	13
9	M+C	ⅡA	24	男	无	暂时	无	15
10	M	Ⅰ	26	男	无	无	无	18
11	M	ⅡA	22	女	无	无	无	13

测量指标		术前						术后
测量指标		患侧		健侧		P		患侧		健侧		P
RH/mm	36.90±2.30		52.12±5.77		0.002^*		42.38±3.92		46.66±4.15		0.003^*
RH-MSP/(°)	10.98±3.52		18.02±3.99		0.024^*		12.02±8.19		15.37±3.30		0.441
RH-FHP/(°)	65.46±7.09		76.13±5.77		0.010^*		69.71±8.34		68.99±5.31		0.726
RH-FP/(°)	13.56±12.21		5.32±3.65		0.146		15.60±8.93		12.09±6.46		0.427
BL/mm	73.96±7.88		84.52±5.39		0.007^*		86.96±4.44		87.34±5.26		0.599
BL-MSP/(°)	31.65±2.81		41.44±5.26		0.003^*		38.50±2.80		35.28±3.94		0.128
BL-FHP/(°)	28.78±6.62		20.54±7.95		0.176		25.59±9.77		26.60±6.75		0.771
BL-FP/(°)	33.07±11.00		39.54±10.84		0.013^*		42.16±9.30		41.21±6.03		0.752

测量指标	术前	术后	P
BL/mm	10.56±4.55	1.14±0.88	0.009^*
RH/mm	14.56±6.01	4.28±1.47	0.014^*
BL-FHP/(°)	11.67±6.53	5.26±4.42	0.040^*
BL-FP/(°)	6.47±3.41	2.78±3.15	0.125
BL-MSP/(°)	9.79±3.34	3.25±3.69	0.024^*
RH-FHP/(°)	10.12±5.52	2.32±1.59	0.042^*
RH-FP/(°)	8.24±10.22	8.33±2.78	0.984
RH-MSP/(°)	6.61±3.93	3.17±1.94	0.034^*

Correction of hemifacial microsomia using preformed titanium mesh combined with contralateral mandibular angle bone graft with CAD/CAM assistance

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