快速原型技术及石膏模型外科技术在下颌骨不对称畸形中的应用及效果评价  

Application and effect evaluation of rapid prototyping technology and plaster model surgery in orthognathic treatment of mandibular asymmetry

作　　者：吴烨[1] 黄跃[2] 谢福平[1] 牛刚[1] 黄立[2] 林李嵩[1,2] 

机构地区：[1]福建医科大学附属口腔医院口腔颌面外科,福建福州350002 [2]福建医科大学附属第一医院口腔颌面外科,福建福州350004

出　　处：《中国口腔颌面外科杂志》2014年第6期503-508,共6页China Journal of Oral and Maxillofacial Surgery

基　　金：2009年中华人民共和国人力资源和社会保障部留学人员科技活动项目择优资助;福建省自然科学基金(2014J01316);福建省教育厅基金(JA11125)~~

摘　　要：目的 :探讨快速原型(rapid prototyping,RP)技术制作的高仿三维头颅模型与精确制取的牙弓石膏模型在面弓介导下精确结合,进行模型外科,用于指导下颌骨不对称畸形患者正颌手术的可行性,并评价其应用效果。方法:15例下颌骨不对称畸形、需要正颌手术的患者均进行全头颅三维螺旋CT扫描,将数据输入快速原型机,制作三维头颅模型,然后将牙弓石膏模型按等比例替换三维头颅模型的牙弓,以组成RP-石膏模型复合体;利用RP-石膏模型复合体进行术前模拟截骨,评价截骨位置及截骨量,评估患者颏部的对称性以及颞下颌关节的改变情况,术后6个月评估手术效果。结果:15例患者术前建立RP-石膏模型复合体,很好地预测了手术效果;2例发现经双侧下颌骨矢状劈开截骨术(BSSRO)后,颏部仍有偏斜,增加颏成形术。术后半年随访,患者对外形感到满意,无颞下颌关节紊乱综合征(TMJ)等并发症。结论:RP-石膏模型复合体可精确模拟截骨,对患者术后颏部及TMJ的改变,正颌手术的效果及可能出现的问题都具有重要指导价值。PURPOSE： Rapid prototyping （RP） technology was employed to make high quality 3-dimensional head simulator, which was then precisely combined with a fine plaster cast of dental arch by facebow for model surgery to guide orthognathic surgery for mandibular asymmetry and evaluate the effect. METHODS： Fifteen patients with dento- maxillofacial deformities underwent spiral CT scan to collect raw data, which was inputted into rapid prototyping machine to generate 3-dimensional head-simulators. The plaster casts of dental arch were subsequently replaced with those of 3- dimensional head-simulators in the same ratio. Finally, RP-plaster cast complexes were formed for simulating osteotomy prior to surgery, in order to assess the position and volume of osteotomy, the symmetry of chin and variation of temporomandibular joint （TMJ）, and surgical effect 6 months after operation. RESULTS： RP-plaster cast complexes from 15 patients were shown to be good for predicting the effect of surgery. Two cases were still found to have mental deviation and chin plasty was carried out after bilateral mandibular sagittal split osteotomy （BSSRO）. The 6-month follow-up results showed the patients were satisfied with their appearance and had no complications including TMJ disorder. CONCLUSIONS： RP-plaster east complex is valuable in precisely simulating osteotomy, contributing to understanding postoperative alteration of chin and TMJ and assessing surgical effect and possible complications.

关 键 词：快速原型技术 RP-石膏模型复合体 正颌外科 

分 类 号：R782.2[医药卫生—口腔医学]