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Objective:To observe the difference in the effect of simple titanium plate internal fixation and titanium plate internal fixation combined with titanium nail intermaxillary traction in the treatment of jaw fractures and their impact on the oral and maxillofacial function of patients.Methods:From August 2016 to May 2021, 94 patients with jaw fractures admitted to the Department of Stomatology, Linyi Central Hospital, Shandong (supplementing the gender, age range and average age of the patients), were divided into 47 cases in the control group, and the titanium plates were used alone, combined operation group 47 cases, titanium plate internal fixation combined with intermaxillary traction with titanium nails. The changes of oral and maxillofacial function and fracture healing were measured before operation and 3 months after operation, and the perioperative indicators and postoperative complications were recorded.Results:Three months after operation, the scores of maxillofacial function, mouth function and masticatory function in the combined operation group (0.52±0.09 points, 0.67±0.12 points, 0.58±0.08 points) were significantly lower than those in the control group (1.05±0.21 points, 1.14±0.22 points, 1.02±0.21 points) ( t=15.90, 12.86, 13.42, P<0.05). The effective rate of the combined operation group was 95.74% (45/47), which was significantly higher than that of the control group (80.85%, 38/47) (χ 2=5.05, P<0.05); there was no significant difference in operation time and hospitalization time between the groups ( P>0.05), the fracture healing time in the combined surgery group (65.02±7.06) d was significantly shorter than that in the control group (82.69±10.25) d ( t=9.73, P<0.05). The postoperative complication rate of combined treatment group was 6.38% (3/47), which was significantly lower than the control group 21.28% (10/47) (χ 2=4.37, P<0.05). Conclusions:In the treatment of jaw fractures, titanium plate internal fixation combined with titanium nail intermaxillary traction treatment can significantly improve the oral and maxillofacial function of patients, promote postoperative fracture healing, improve curative effect and reduce the incidence of complications compared with simple titanium plate internal fixation.
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Objective@#To investigate the treatment methods of chronic prolonged mandibular dislocation.@*Methods@#Surgical reduction was performed in a case of temporomandibular joint dislocation over 6 months after manual reduction failure. The flap was removed under general anesthesia, and the bone of the condyle were removed. The articular disc was aligned and incision was sutured, and the procedure was combined with intermaxillary fixation for a correct occlusion and traction. After the operation, the surgical efficacy was observed, and the related literature was reviewed. @*Results@#The patient recovered well after the operation; the mouth opening was 3 cm, and the occlusion was normal. No recurrence was observed after 10 months of follow-up. The literature shows that surgery is a common treatment for temporomandibular joint dislocation after the failure of manual reduction, and postoperative patient education can reduce recurrence and complications. @*Conclusion @#Surgery combined with intermaxillary traction can effectively treat chronic prolonged mandibular dislocation.
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Objective:To analyse the methord and effects of intermaxillary traction(IMT)screws used in the treatment of jaw frac-ture.Methods:In the treatment of 1 68 cases of jaw fracture IMT screws were used for the restoration of normal and stable occlusion. The screw number,position,traction effect and postoperative complications of the treatment were analysed.Results:705 screws were used in 168 patients,4 screws were used in each of 147 cased (88%),6 in 12(7%),5 in 9(5%).336(47.7%)screws were fixed between the roots of first and second premolar,292(41 .4%)between the roots of canine and first premolar,50 (7.1%)be-tween the roots of second premolar and first molar,27(3.8%)between the other tooth roots.Normal postoperative occlusion relation was achived by the use of screws in 92 cases without traction.Occlusion disharmony or deviation was found in 76 cases by the used of screws and was restored to normlal by 1 4-day traction in 71 cases.The total efficiency of the treatment was 97%.Pain of the mucosa surrounding the screws was observed in 23 cases (1 3.7%).Root damage,traction screw loosening and adjacent tooth dislocation were observed in 1 3(1 .8%),1 1 (1 .6%)and 2(0.3%)cases respectively.Conclusion:For the fixation of IMT screws,the posi-tions between tooth root from canine to first molar were most common and safe.The fixation point should be in 5 ~8mm below the gin-gival margin.Use of 4-6 screws can meet treatment need.
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OBJECTIVES: The anterior open bite with temporomandibular disorders (TMD) is one of the most challenging cases both orthodontically and surgically. We introduce an intermaxillary traction treatment for patients with anterior open bite and TMD using a skeletal anchorage system (SAS). MATERIALS AND METHODS: This study was comprised of 52 patients with anterior open bite and TMD. A total of four mini-screws were inserted, two screws each into the maxilla and mandible, to obtain a class II pattern of elastic application with 120-200 g force. Adjunctive muscle relaxation treatments, such as splint therapy, medication, and botulinum toxin injection were applied during or before intermaxillary traction. At least one treatment among adjunctive muscle relaxation treatment, mentioned above, was applied to 96.2% of patients. We evaluated the clinical characteristics of patients, TMD symptom changes, amount of open bite improved. The degree of open bite improvement was compared between the open bite-reduced group (21 patients) and not-reduced group (5 patients). RESULTS: TMD symptoms (muscle/joint pain, joint sound, mouth opening) remained or improved in most patients, and worsened in about 10% of patients for each items. Anterior open bite was improved by a mean of 1.75 mm (P<0.01) during treatment. The open bite-reduced group exhibited a significant open bite improvement compared to the not-reduced group (P<0.05), with 37% of open bite improvement occurring during the first 3 months of treatment. CONCLUSION: The intermaxillary traction technique using SAS is a valid modality for correction of anterior open bite and improvement of TMD symptoms.
Subject(s)
Humans , Arthralgia , Botulinum Toxins , Gravitation , Malocclusion , Mandible , Maxilla , Mouth , Muscle Relaxation , Open Bite , Phenothiazines , Splints , Temporomandibular Joint Disorders , TractionABSTRACT
Objective To evaluate the reason of the complications after treating by the intermaxillary traction with the titanium screw and put forward the measures of prevention these complications in mandibular fractures.MethodsOne hundred and twenty-six cases with mandibular underwent intermaxillary traction and fixation with tapping titanium screw were observed and counted for their complications in 1-30 days after finishing the operation.Summarized and analyzed the reasons of the complications.ResultsThe rate of complications was 9.52％(12/126),4 cases of titanium screw loosen,2 cases of bad occlusion,1 case of titanium screw fallen off,1 case of titanium screw around infected,1 case of root tip damage,1 case of titanium screw maxillary penetrated into the sinus,1 case of nerve injury,1 case of dental ulcer.Conclusion The intermxillary traction with the titanium screw is simple,safety and healthy method,but the postoperative complications also don't allow to ignore,surgeons should be controlled strictly,standardized operation,try to avoid complications.