骨性Ⅲ类面形患者数字化正颌外科治疗  

Digital orthognathic surgery in the treatment of skeletal class Ⅲ type patients

作　　者：商洪涛 史雨林 白石柱 赵晋龙 刘彦普 SHANG Hong-tao SHI Yu- Lin BAI Shi-zhu ZHAO Jin-long LIU Yan-pu(State Key Laboratory of Military Stomatology ＆ National Clinical Research Center for Oral Diseases ＆ ShanXi Clinical Research Center for Oral Diseases ＆ Department of Oral and Maxillofacial Surgery, School of Stomatology, The Fourth Military Medical University, Xi＇an 710032, China)

机构地区：[1]军事口腔医学国家重点实验室国家口腔疾病临床医学研究中心陕西省口腔疾病临床医学研究中心第四军医大学口腔医院颌面外科,陕西西安710032 [2]军事口腔医学国家重点实验室国家口腔疾病临床医学研究中心陕西省口腔医学重点实验室第四军医大学口腔医院修复科

出　　处：《中国美容整形外科杂志》2016年第12期713-716,共4页Chinese Journal of Aesthetic and Plastic Surgery

摘　　要：目的提出一种计算机辅助设计正颌外科手术并3D打印手术截骨及定位导板的方法,评估其临床应用价值。方法该研究选取34例需接受正颌手术治疗的住院患者,利用ProPlan CMF 2.0软件进行术前虚拟手术设计,并在3-matic软件中设计完成虚拟截骨和定位导板,将设计的截骨和定位导板3D打印用于现实手术中,以指导术中方案精准实施。通过比较术前计划与术后CT进行准确性评估。结果 34例患者均在截骨导板和定位导板的指导下完成手术。术后患者咬耠功能良好,外形满意,术前规划与术后CT骨组织重叠比对色阶图比较误差,成组t检验显示,差异无统计学意义,表明结果在临床可接受范围内。结论该数字化正颌手术系统流程可以取得良好的手术准确性,是一种虚拟现实技术的良好体现,可提高正颌手术的精确性。Objective To propose a method for computer-aided design of orthognathic surgery and surgical osteotomy and localization of 3D printing plate, to evaluate its clinical application value. Methods This study selected 34 cases in our department for orthognathic surgery. Preoperative virtual prosthetic design was performed using ProPlan CMF2.0 software. 3-matic software was used to design and complete the virtual osteotomy and positioning guide. The designed osteotomy and positioning guide plate was printed by 3D technology. These are used in the actual operation to guide the precise implementation of the surgical program. Accuracy as- sessment was performed by comparing preoperative planning with postoperative CT. Postoperative patient bite function is good, satisfactory shape, preoperative planning and postoperative CT bone overlap. Results All 34 patients completed the surgery under the guidance of the osteotomy plate and positioning plate. The patients achieved good occlusal function and satisfactory appearance after the operation. Preoperative and postoperative CT comparison results supported our conclusion. Group t test shows no significant difference, indicating that resuits were in a clinically acceptable range. Conclusion The digital surgical procedure can achieve good accuracy, which is a good embodiment of virtual reality technology. It can improve the accuracy of the surgery.

关 键 词：正颌手术 数字化 导板 精准医学 

分 类 号：R782.2[医药卫生—口腔医学]