【摘要】 目的通过应用口内型牵引器行牵引成骨延长下颌骨，矫治小下颌及偏颌畸形，对牵引成骨技术在颌骨畸形矫治中的应用价值和技术手段进行初步的评价。方法８例小下颌患者接受了双侧下颌骨牵引成骨治疗。安置牵引器后第５～６天开始牵引，６例牵引速度为０．８ｍｍ／ｄ，２例为１ｍｍ／ｄ；牵引到位后固定７１～１３９天拆除牵引器。结果最大牵引幅度２４．４ｍｍ，最小幅度８．５ｍｍ。所有病例在拆除牵引器时均能看到完全成熟的新骨。最长随访期为１０个月，无复发倾向。小下颌畸形、颜面不对称畸形均得到了明显的改善。牵引过程中，１例出现颊部软组织感染，１例下唇麻木。未出现牵引器松脱、未成骨及骨过早联合等情况。结论牵引成骨技术因其手术较小、操作简单，可以避免植骨且并发症少，应用于颌骨发育不良的矫正治疗，不失为一种有效的治疗手段；但该技术并不能完全作为单一的矫治手段进行颌面畸形的外科治疗。此外，正确的牵引方向的控制尚有待于进一步研究。更多还原

【Abstract】 Objective To evaluate the results of distraction osteogenesis for correcting the micromandible with intraoral device.Methods 8 cases of micromandible resulted from temporomandibular joint (TMJ) ankylosis and first and second branchial arch syndrome had received the management of distraction osteogenesis. In these cases there were 5 females and 3 males. The age of the patients were 10～43, and at an average age of 20.25. There were 5 micromandible associated with obvious mandibular asymmetry. The osteotomy was performed on bilateral mandibular bodies by intraoral approach. Elongation was started on the 5th 6th postoperative day at a rate of 0.8～1.0mm per day.Results The distraction was fulfilled with a range of 8.5～24.4mm. Pain appeared in osteotomy region when the 1mm distraction was carried out once a day and disappeared when it was divided into twice a day. Mandbular lengthening was successful. Micromandibular and facial asymmetries were corrected satisfactorily. The follow up period ranged from a minimum of 1 month to a maximum of 10 months. There was no recurrence. There were one case of soft tissue infection and one case of lower lip numbness, no other disturbance as wound healing, and pseudoarthrosis occurred. Conclusion On account of its advantage of little injury, avoiding bone grafting and few complications, intraoral distraction osteogenesis is a valuable approach to correct the mandibular agenesis. In the procedure of management of the mandibular deformities, to achieve a better result, distraction osteogenesis must be combinded with other orthognathic operations. How to control the direction of distraction is a problem that needs further study.更多还原