|
- 2018
3D打印截骨导板辅助颏成形术的临床应用研究
|
Abstract:
摘要 目的: 设计并通过3D打印的方法制造用于颏成形术的导板系统,评估其临床应用的准确性,以期为临床提供参考。方法: 接受颏成形术治疗的患者12例,平均年龄22.6岁(18~27岁)。所有患者术前均行头颅CT扫描,将CT数据导入Mimics 16.0,重建出下颌骨的三维模型,用3-matic 8.0设计截骨导板和定位导板,设计好后采用光敏树脂用三维打印机打印制作,在术中应用。结果: 所有患者均釆用3D打印的导板完成截骨,术中导板置入顺利,未出现碎裂、变形等问题。所有颏成形术均顺利完成。与术前规划相比,术后实际中心点冠状向、矢状向和垂直向位移分别为(0.12±0.27)mm、(-0.57±0.18) mm和(-0.22±0.36) mm,差异无统计学意义;俯仰角、侧滚角和偏航角分别为(2.14±1.02)°、(0.45±0.64)°、(0.24±0.17)°, 差异无统计学意义。结论: 该颏成形术导板系统可取得较好的手术准确性,是一种将术前虚拟方案转化至术中实际的可靠方法,外科医生可以使用此技术来获得更好的手术效果
[1] | 张庆福, 刘刚,刘国勤.个体化3d打印钛合金下颌骨植入体的设计制作与临床应用[J] .口腔医学研究,2015,31(1)∶48-51 |
[2] | 赵一姣, 原福松, 谢晓艳,等.牙颌模型激光扫描数据与锥形束ct数据配准方法的精度比较[J] .中华口腔医学杂志,2013,48(3)∶173-176 |
[3] | Yamauchi K, Yamaguchi Y, Katoh H, et al. Tooth-bone CAD/CAM surgical guide for genioplasty [J] . Br J Oral Maxillofac Surg, 2016,54(10)∶1134-1135 |
[4] | 沈映勋,张策,曹德君.颏成形术发展及现况[J] .组织工程与重建外科, 2015,11(2)∶116-119 |
[5] | Polley JW , Figueroa AA. Orthognathic positioning system: intraoperative system to transfer virtual surgical plan to operating field during orthognathic surgery [J] . J Oral Maxillofac Surg, 2013,71(5)∶911-920 |
[6] | Li B, Wei H, Zeng F, et al.Application of a novel three-dimensional printing genioplasty template system and its clinical validation: a control study [J] . Sci Rep, 2017, 7(1)∶5431-5438 |
[7] | 尹琳, 张智勇, 石蕾,等.颏部美容成形术相关并发症探讨[J] .中华医学美学美容杂志, 2015,1(6)∶371-373 |
[8] | 周小义,刘尧,叶斌,等.3d打印导板辅助髁突骨软骨瘤及继发复杂牙颌面畸形的手术治疗[J] .口腔医学研究,2017,33(2)∶166-169 |
[9] | 李彪, 魏弘朴, 姜腾飞,等.三维打印颏成形术导板的临床应用及准确性初探[J] .中华口腔医学杂志, 2016,51(11)∶646-650 |
[10] | Hsu SS, Gateno J, Bell RB ,et al. Accuracy of a computer-aided surgical simulation protocol for orthognathic surgery: a prospective multicenter study [J] . J Oral Maxillofac Surg, 2013,71(1)∶128-142 |
[11] | Yuan P, Mai H, Li J, et al. Design, development and clinical validation of computer-aided surgical simulation system for streamlined orthognathic surgical planning [J] . Int J Comput Assist Radiol Surg,2017,12(12)∶2129-2143 |
[12] | Lee EI.Aesthetic alteration of the chin [J] . Semin Plast Surg, 2013,27(3)∶155-160 |
[13] | Qiao J, Fu X, Gui L, et al. Computer image-guided template for horizontal advancement genioplasty [J] . J Craniofac Surg, 2016, 27(8)∶2004-2008 |
[14] | 陈莹, 牛峰, 归来,等.三维数字化在颏部水平截骨术中的应用[J] .中国美容整形外科杂志,2017,28(1)∶16-18 |
[15] | Assis A, Olate S, Asprino L, et al. Osteotomy and osteosynthesis in complex segmental genioplasty with double surgical guide [J] . Int J Clin Exp Med, 2014,7(5)∶1197-1203 |