个体化模板在单侧颧眶颌复合体骨折复位中的临床应用  

Individual computer-aided design templates for accurate reduction of unilateral zygomatic-orbitalmaxillar complex bone fractures

作　　者：李建平[1] 张兴[2] 彭伟[3] 陈松龄[3] 

机构地区：[1]中山市人民医院口腔分院,528403 [2]广东省中医院口腔科,广州510120 [3]中山大学附属第一医院口腔科,广州510080

出　　处：《中华口腔医学研究杂志（电子版）》2016年第6期414-420,共7页Chinese Journal of Stomatological Research(Electronic Edition)

基　　金：国家自然科学基金(81371111);广东省自然科学基金(2014A030313059);广东省科技计划(2013B010406006);中山市卫计局科技项目(2014J038)

摘　　要：目的探讨应用个体化模板提供外科设计及术中精确导向定位的临床意义。方法选择单侧颧眶颌骨折患者25例,通过术前三维CT扫描,对颅颌骨进行重建。采用计算机辅助设计（CAD）及相应快速成形技术（RP）在健侧的颅面中部骨结构CT数据上制作患侧面中部骨表面的多块（3~4块）个体化模板,利用模板作为术中导向,精确复位颧眶颌复合体（ZOMC）骨折。结果所有患者中,由健侧面中部骨结构CT数据重建的患侧虚拟面中部骨结构继之形成的表面外形模板,均能很好的应用于骨折复位中,各标志点术后水平非对称率均小于3%,单侧ZOMC骨折均获得对称性的复位。结论应用CAD和RP联合设计,制作多块个体化模板,通过导向定位精确复位ZOMC骨折,是ZOMC骨折复位重建的新的成功应用。Objective To use the individual surface templates of craniomaxillofacial bone inaccurate reduction and reconstruction of zygomatic-orbital-maxillar bone fracture. Methods Twenty-fivecases of unilateral zygomatic-orbital-maxillar bone fracture were observed in this study. Preoperatively,craniomaxillofacial bones were scanned by CT and 3D surface reconstruction of skulls were performed.Then,3D reconstructions of skull were performed through CT scans. Individual surface templates offractured side craniomaxillofacial bone,made by technology of electronic computer-aided design（CAD）and rapid prototyping（RP）base on the CT data of unfractured side,were used to guide reduction andreposition of fractured and migrated zygomatic- orbital- maxillar complex（ZOMC）. Results Among allcases,the individual CAD templates,were well manipulated in surgery,guiding perfectly reposition andreconstruction of ZOMC. The postoperative horizontal asymmetric rates of each landmark are less than 3%.Conclusion On the basis of CAD and RP treatment,the individual templates can be perfectly applied toguide reposition and reconstruction of ZOMC.

关 键 词：计算机辅助设计 快速成型 颧骨骨折 眶骨折 个体化模板 

分 类 号：R782.4[医药卫生—口腔医学] R779.1[医药卫生—临床医学]