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- 2018
辅助髁突定位改良型咬合导板的设计与制作
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Abstract:
摘要 目的: 运用计算机辅助设计和制作一种在下颌矢状截骨手术中准确控制髁状突位置的咬合-定位一体化装置,并通过实验验证其准确性。方法: 随机选取在南昌大学附属口腔医院口腔颌面外科就诊,完成术前正畸治疗拟行正颌手术的患者10例,共20侧髁突。行头颅及石膏模型CT扫描,使用Mimics 17.0 软件生成上、下颌三维模型,按手术计划完成虚拟截骨及骨块移动,建立新的上下颌骨空间关系,将髁突的位置信息记录为虚拟组数据。使用Freeform12.0软件设计咬合导板和下颌近心端定位导板,并通过连接杆将咬合导板与定位导板实现一体化。使用3D打印机分别打印一体化定位装置、下颌骨近端骨块、远端骨块等实物模型部件,利用一体化定位装置将实物部件连为一体后行CT扫描,将所得 Dicom 数据作为模型组数据导入到Mimics 17.0 软件中。测量虚拟组和模型组中3个髁突标志点的线性差异及坐标差异,评价髁突位置及空间姿态的变化,统计学分析使用均方根偏差(RMSD)分析。结果: 3固位臂设计对下颌近心端具备良好的固位效果,统计学分析虚拟手术组和模型手术组的髁突位置信息显示了非常好的一致性,最大位置RMSD差异为 0.738 mm,最大姿态角度RSMD差异为1.1°。结论: 计算机辅助设计与制作的咬合-定位一体化导板在体外模型实验中能够对髁状突进行精确定位,且设计、制作简单,有望作为一种正颌手术中髁突定位装置的选择
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