摘要目的 探讨假体隆颏术后颏部骨吸收的可能原因及治疗.方法 分析假体隆颏术后因骨吸收进一步治疗患者12例,通过临床手术所见和放射学检查结果,观察局部颏骨吸收情况.结果 发生轻度或无骨吸收者7例骨吸收(≤2 mm),其中硅橡胶假体5例,膨体聚四氟乙烯假体2例.发生中度骨吸收者3例(骨吸收＞2 mm,而≤4 mm),均为硅橡胶假体.发生重度骨吸收者2例(骨吸收＞4 mm),硅橡胶假体1例,膨体聚四氟乙烯假体1例.所有患者均接受假体取出术,其中8例行颏成形术,2例行高密度多孔聚乙烯隆颏术进一步治疗,效果满意.结论 颏肌-假体-骨之间的平衡失调是引起骨吸收的最主要原因之一.因此,对于轻度和中度小颏畸形可以选用合适的假体进行隆颏术,但需长期随访观察,对于重度的小颏畸形,或伴有(牙合)颌面畸形和颏肌功能亢进的小颏或者小下颌患者不应选用假体隆颏术.否则,会发生严重骨吸收,需要采用截骨成形术进行矫正.

abstractsObjective To analyze and discuss the possible reasons of the bone resorption beneath the prostheses after chin augmentation.Methods Twelve patients were admitted to our department for further correction after chin augmentation with materials.The bone resorption was observed through the clinical research and X-ray examination.Results All the patients were underwent the removal of the materials,genioplasty was performed in 8 patients,and two patients were treated by chin augmentation with polyethylene.All the patients were satisfied with their facial contouring.Mild bone resorption was found in seven patients (depth of bone resorption ≤2 mm),in which five patients were used with silicone materials,two patients were performed with expanded polytetrafluoroethylene implants.Moderate bone resorption was seen in three cases.All of them were used with silicone implants (2 mm ＜ depth of bone resorption ≤4 mm).Severe bone resorption happened in two patients (depth of bone resorption ＞4 mm).One was used with silicone implant,and the other one was carried out with expanded polytetrafluoroethylene implant.Conclusions The imbalance among mentalis muscle,materials and underlying bone might be one of the key reasons.Thus for mild and moderate microgenia cases,chin augmentation with material is suitable,while long-term fellow-up study is necessary.But for the cases of severe mirogenia or microgenia and micrognathia with dentofacial deformity or mentalis muscle hyperactivity,genioplasty might be performed as well to correct their deformities.