18例頦部取骨骨移植術(shù)供區(qū)軟組織切口效果的臨床觀察

1、18 18 例頦部取骨骨移植術(shù)供區(qū)軟組織切口效果的臨床觀察 例頦部取骨骨移植術(shù)供區(qū)軟組織切口效果的臨床觀察周磊，徐淑蘭，黃建生，徐世同，宋光保，張雪洋An An observation observation on on the the result result of of the the incision incision healing healing of of the the donor donor sites sites i

2、n in 18 18 cases cases undergoing undergoing the the chin chin bone bone grafting grafting procedure procedureZHOU Lei, XU Shu-lan, HUANG Jian-sheng, XU Shi-tong, SHONG Guang-bao, ZHANG Xue-yang.（Affiliated Stomato

3、logical Hospital of Southern Medical University , Guangdong Provincial Stomatological Hospital, Guangzhou, 510280, Guangdong province , China）【Abstract Abstract】Objective: Objective: To summarize the results of wounds h

4、ealing process in two incision design at donor sites in the chin bone grafting procedure ;Introduce the better surgical procedure for the donor sites. Methods: Methods: 18 consecutive patients underwent onlay bone graf

5、ting from the mandibular symphysis for harvesting intraoral autografts. 8 cases via incision at the mandibular vestibular groove and 10 cases via incision at the attached gingiva. The wound healing after the

6、 operation was observed . Results: Results: In the vestibular groove incision group , the wound healed uneventfully in 6 of 8 cases, there were dehiscence in 2 cases ,the scars were obvious i

7、n all the case of this group . In the attached gingival incision group, all the wound of 10 cases healed uneventfully with very unconspicuous scars . Conclusion: Conclusion: The attached gingival incision

8、 design is profitably for adequate access to the donor sites and easier adaptation of the flap for tension-free closure.Keywords: Keywords: bone graft ; Onlay bone graft; Incision design[摘要 摘要] 目的 目的 總結(jié) 18 例頦部供

9、骨骨移植術(shù)中兩種軟組織切口設(shè)計的傷口愈合情況。對其中較理想的供區(qū)手術(shù)方式進(jìn)行了介紹。方法 方法 18 例下頜骨頦部供骨 Onlay 植骨的患者，隨機選擇了 8 例采用前庭溝切口設(shè)計；10 例患者采用附著齦切口設(shè)計。結(jié)果 結(jié)果 8 例前庭溝切口設(shè)計者當(dāng)中，6 例一期愈合，2 例出現(xiàn)傷口裂開；所有 8 例患者術(shù)后皆形成較為明顯的瘢痕。10 例附著齦切口設(shè)計患者術(shù)后傷口皆一期愈合，且愈合后無明顯的瘢痕形成。結(jié)論 結(jié)論 附著齦切口設(shè)計能提供

10、較理想的手術(shù)入路并能較好地達(dá)到無張力復(fù)位組織瓣。[關(guān)鍵詞 關(guān)鍵詞] 骨移植；Onlay 骨移植；切口設(shè)計下頜骨頦部可提供相對豐富的松質(zhì)骨及皮質(zhì)骨來源，在牙槽嵴骨增量技術(shù)中是常用的塊狀骨供骨區(qū)。目前有關(guān)頦部取骨的手術(shù)操作中，對取骨的技術(shù)本身有較多的關(guān)注，但對于頦部取骨時軟組織切口的研究，則較少有報道，但軟組織切口的選擇，對于減少術(shù)后并發(fā)癥，術(shù)后的正常愈合進(jìn)程有很大關(guān)系。本文對頦部取骨的兩種軟組織切口進(jìn)行比較研究并重點介紹了根據(jù)我們的臨床

11、實踐認(rèn)為較好的附著齦切口手術(shù)方式，希望對此類手術(shù)的開展有所借鑒。＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿[基金項目 基金項目] 廣東省科技三項經(jīng)費計劃項目 2006B19901006 國家十一五科技支撐計劃2007BAI18BO6[作者單位 作者單位]南方醫(yī)科大學(xué)附屬口腔醫(yī)院 廣東省口腔醫(yī)院，廣東廣州 510280[通訊作者 通訊作者]周磊，Tel. 020-84233801 ，F(xiàn)ax. 020-8443

12、3177，Email. 圖2 附著齦切口，顯露供骨區(qū)。Fig 2 incision at the attached gingiva, the donor site was exposed.圖3 縫針從頰側(cè)尖牙與雙尖牙牙間乳頭處穿向舌側(cè)，再從舌側(cè)尖牙與側(cè)切牙間穿向唇側(cè)，穿過下游離瓣后于唇側(cè)打結(jié)。Fig 3 The needle from the buccal to the lingual pass through the papilla

13、 between the 43 and 44.then pass through the papilla of 43 and 42 to the buccal site ,pass through the lower flap ,tie a knot. 圖4 繼續(xù)按懸吊式縫合法關(guān)閉傷口。Fig 4 Continue the suture using suspensory technique. 圖5 最后按圖示方式打結(jié)。Fig