中国口腔医学继续教育杂志 ›› 2025, Vol. 28 ›› Issue (5): 360-366.DOI: 10.12337/zgkqjxjyzz.2025.05.009

• 病例报告 • 上一篇    下一篇

斜面导板改善下颌骨药物相关性颌骨坏死的咬合关系1例

何金媛, 孙国文*   

  1. 南京大学医学院附属口腔医院口腔颌面头颈外科,南京市口腔医院,南京大学口腔医学研究所
  • 出版日期:2025-09-30 发布日期:2025-09-30
  • 通讯作者: * 孙国文,联系方式:025-83620326,电子邮箱:238957@sina.com,通讯地址:江苏省南京市玄武区中央路30号,210008

One Case of the Guide Plate to Improve the Occlusal Relationship of Mandibular Medication-related Osteonecrosis of the Jaw

Jinyuan He, Guowen Sun*   

  1. Department of Oral and Maxillofacial-Head and Neck Surgery, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Institute of Stomatology, Nanjing University, Nanjing, Jiangsu Province, P.R. China
  • Online:2025-09-30 Published:2025-09-30
  • Contact: Guowen Sun. Tel: 025-83620326. Email: 238957@sina.com. Address: No.30 Central Road, Xuanwu District, Nanjing 210008, Jiangsu Province, P.R. China.

摘要: 目的:本文旨在报道1例诊断为药物相关性颌骨坏死(medication-related osteonecrosis of the jaw,MRONJ)3期伴下颌骨病理性骨折患者的手术治疗过程与疗效,以探索针对该类患者在节段性截骨后未行重建钛板修复的临床经验。诊治经过:根据美国口腔颌面外科医师协会对MRONJ的定义以及提出的分期标准,对该患者做出明确诊断(下颌骨3期)。完善术前检查后制定手术方案,与患者及家属沟通后选择仅行下颌骨节段性截骨,术后制作带翼斜面导板以改善患者术后的咬合功能。结果:本病例达到了恢复健康并重建功能的诊治目标,患者对目前治疗及功能恢复效果表示满意。结论:对于不能耐受复杂全麻手术的下颌骨3期MRONJ患者,可考虑仅行节段性截骨术并制作带翼斜面导板以改善咬合关系。

关键词: 药物相关性颌骨坏死, 病理性骨折, 节段性截骨术, 带翼斜面导板, 功能

Abstract: Objective: To report the surgical treatment process and efficacy of a patient diagnosed as stage 3 medication-related osteonecrosis of the jaw(MRONJ) with pathological fracture of the mandible, and to explore the clinical experience of segmental osteotomy without titanium plate repair reconstruction. Diagnosis and treatment: According to the definition of MRONJ and the proposed staging criteria of the American Association of Oral and Maxillofacial Surgeons(AAOMS), the patient was diagnosed definitively stage 3 of mandible. The surgical plan was made after the preoperative examination was completed. After communicating with patient, only segmental osteotomy of mandible was selected. After operation, a winged inclined guide plate was made to improve the occlusal function of the patient. Results: This case achieved the goal of recovery and functional reconstruction, and the patient was satisfied with the current treatment and functional recovery. Conclusions: For mandibular stage 3 patients who cannot tolerate complex general anesthesia surgery, segmental osteotomy alone and a winged inclined guide plate may be considered to improve occlusal relationship.

Key words: medication-related osteonecrosis of the jaw, pathological fracture, segmental osteotomy, winged inclined guide plate, function