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目的:探讨上颌翼状导板在上下颌骨联合切除术后早期赝复治疗中的应用价值。方法:收集10例因口腔癌根治而切除上下颌骨而未进行同期功能性重建的患者,其中2例术前获得口内牙列印模,8例因术前开口受限而在术后2周获得口内印模。在初步印模基础上制作个别托盘后,取工作模型、咬合记录并上架。利用上颌余留牙设计固位卡环,制作带有翼状导板的腭护板。患者于术后1周开始佩戴。结果:10例患者在术后1～3个月的康复训练后,无饮水返流及鼻漏气,腭咽闭合功能良好,上下颌余留牙咬合关系良好。去除翼状导板后,能够自主咬合,达到最大咬合面积。结论:腭护板联合翼状导板不仅能够保护上颌骨切除术区创口,早期分隔口鼻瘘,而且能够尽早纠正上下颌骨联合切除后的错。为二期永久赝复体制作提供了条件。
Objective: To investigate the value of maxillary wing guide in the early period of prosthetic rehabilitation after combined maxillary and mandibular resection. METHODS: Ten patients who underwent radical resection of the upper and lower jaws without functional reconstruction were recruited. Two of the patients received preoperative oral impressions and the other eight received preoperative implants, Obtain mouth impression. After the initial impression based on the production of individual pallets, take the working model, occlusion record and on the racks. Using the retaining jaws of the maxillary remnants to design retention clasps, a palatal guard with a wing-shaped guide was made. Patients started to wear one week after surgery. Results: After 1 to 3 months of rehabilitation training, 10 patients had no reflux of water and nasal leakage, and the velopharyngeal closure function was good. The occlusion between the upper and lower jaws was good. After removing the wing-shaped guide plate, it can self-bite to reach the maximum occlusion area. Conclusion: The palate guard plate combined with the wing guide plate can not only protect the wounds in the maxillary resection area, divide the oral and nasal fistula early, but also correct the malocclusion after the maxillary and mandibular resection. For the two permanent prosthesis production provided the conditions.