3D打印个体化钛板在正颌手术中的应用及其准确性评价  

Accuracy of 3D printing individual titanium plates for maxillary repositioning in orthognathic surgery

作　　者：李彪[1] 姜腾飞[1] 沈舜尧[1] 蔡鸣[1] 姜闻博[2] 沈国芳[1] 王旭东[1] 

机构地区：[1]上海交通大学医学院附属第九人民医院·口腔医学院口腔颅颌面科,上海市口腔医学重点实验室,上海200011 [2]上海交通大学医学院附属第九人民医院骨科,上海200011

出　　处：《中国口腔颌面外科杂志》2016年第5期419-424,共6页China Journal of Oral and Maxillofacial Surgery

基　　金：国家自然科学基金(81271122);上海市高峰学科建设计划(20152225);上海市市级医院新兴前沿技术联合攻关项目(SHDC12013103);上海交通大学“医工交叉研究基金”(YG2015QN07)

摘　　要：目的:利用计算机辅助技术结合钛金属3D打印技术设计并制作适用于正颌外科中上颌骨手术的个体化钛板,并验证其临床应用的可行性和准确性。方法:纳入8例临床诊断为牙颌面畸形的患者。所有患者均使用计算机辅助模拟技术进行手术方案设计。根据患者手术方案,设计上颌骨手术截骨导板和个体化钛板,术中用于指导截骨和完成上颌骨骨块的定位和固定。患者完成手术后,将术后CT与术前计划进行匹配,通过比较术后实际上颌骨与术前方案的位移误差和角度误差,评估个体化钛板定位的准确性。采用SPSS 13.0软件包对数据进行统计学分析。结果:手术均顺利完成,患者和手术医师均对手术效果满意。使用均方根差分析显示,上颌骨最大位移误差为0.64 mm,最大角度误差为1.65°;上切牙中线水平向位移误差为0.32 mm。结论:初步研究结果显示,在个体化钛板和截骨导板指引下,按照术前虚拟手术设计,准确完成截骨和上颌骨的术中定位,是一种将术前设计转换为术中实际的可靠方法。PURPOSE： To develop and validate the technique of using individual titanium plates for maxilla in orthognathic surgery. The individual titanium plates were designed in the computer and fabricated using 3D printing technique. METHODS： Eight patients with dental maxillofacial deformities were enrolled. Surgeries were planned with computer-aided surgical simulation planning method. Osteotomy guides and individual titanium plates were used in this technique to separately guide the osteotomy and repositioning for the maxilla during operation without surgical splints. The outcome evaluation was completed by comparing planned outcomes with postoperative results of all patients enrolled. The outcome measurements were the linear and angular differences for the maxilla when the planned and postoperative computed tomography models were registered at the cranium. Statistical analysis was performed, and the accuracy was reported using root mean square deviation （RMSD） with SPSS 13.0 software package. RESULTS＂ All surgeries were successfully completed using the technique of individual titanium plate. The preliminary results showed no significant difference for maxilla reposition. The largest RMSDs were 0.64 mm and 1.65° for the maxilla, and 0.32 mm for upper dental midline in mediolateral direction. CONCLUSIONS： The results showed that individual titanium plates could provide a reliable method for transfer of orthognathic surgery planning.

关 键 词：正颌外科 计算机辅助设计 三维打印 定位 准确性 

分 类 号：R782.2[医药卫生—口腔医学]