计算机导航技术在下颌骨缺损种植修复重建的临床研究  

Computer navigation for restoration and reconstruction on mandibular defect implant: a clinical research

作　　者：范亚伟[1] 齐鸿亮[1] 范慧芳[1] 孙福星[1] 

机构地区：[1]山西医科大学第一医院口腔科,太原030001

出　　处：《中国药物与临床》2015年第7期909-911,共3页Chinese Remedies & Clinics

基　　金：山西省社会发展科技攻关计划项目(20120313021-9)

摘　　要：目的探讨应用锥形束CT(CBCT)及Simplant软件导航下颌骨缺损行腓骨重建后种植体修复辅助设计的临床应用效果及其价值。方法收集6例下颌骨大型缺损并行腓骨肌皮瓣双叠移植修复的患者,术后2年复诊患者肿物无复发。对患者的下颌缺损部位进行CBCT扫描得到DICOM数据,将数据导入Simplant软件进行三维重建,测量修复重建后的下颌骨宽度及高度,利用软件的导航技术模拟出种植体最佳的植入位置及深度,选择适合的种植系统,设计并辅助制作种植导板,在导板的引导下进行精确的种植。结果术后半年观察,6例患者种植体骨结合良好,术后行种植支持的固定义齿修复,咬合关系良好,面型恢复满意。1例患者后磨牙区牙龈出现红肿疼痛,经局部冲洗及抗炎治疗1周后,炎症减轻,2周后牙龈肿胀消除、颜色恢复正常。结论运用CBCT及Simplant软件导航,可以更好地评估下颌骨大型缺损自体骨移植后的骨量,精确种植位置,进一步辅助下颌骨缺损后的种植修复。Objective To investigate the clinical effect and the value of cone-beam computed tomography（CBCT） combined with Simplant software navigation on assistant design of the implant restoration in mandibular defect and fibular reconstruction. Methods Six patients with large mandibular defects, who underwent the restoration operation of double-fold fibular myocutaneous flap implantation without at 2 years after the operation, were included in the study. All six patients were without masses relapse at two years after operation. The DICOM data of the mandibular defect area were obtained using CBCT scan, then the data were transferred into Simplant software for three dimension-al reconstruction. The width and height of the mandible were measured after reconstruction. The navigation technology of Simplant software was used to simulate the optimal location and depth of the implant, select the appropriate implant system, design and assist the manufacture of implanting guide plate, which was used to guide precise implantation.Results At half a year of follow-up after the operation, all six patients showed good osseointegration of the implants.Also, all patients showed good occlusion and satisfied facial recovery after undergoing postoperative restoration of the implant-supported fixed denture. One patient showed swelling and pain at the gingiva in the posterior molar area. The inflammation was alleviated at one week after local brushing and anti-inflammatory treatment. The gingival swelling was eliminated with normal color after two weeks. Conclusion Using CBCT and Simplant software navigation can provide better evaluation on bone mass of autogenous bone graft for the reconstruction of large mandibular defect, con-firm the accurate location of implantation, and further assist the implant restoration of mandibular defect.

关 键 词：下颌假体植入 治疗 计算机辅助 牙种植体 

分 类 号：R782.4[医药卫生—口腔医学]