3D打印技术在髂骨移植修复下颌骨缺损中的应用研究  

Effects of mandibular defect reconstruction by using the computer-assisted pre-bent individual reconstruction plate and nonvascularized iliac crest bone graft

作　　者：罗婷苑 张翔[1] 张森林[1] 

机构地区：[1]南方医科大学南京临床医学院,南京军区南京总医院口腔科,江苏南京210002

出　　处：《临床口腔医学杂志》2017年第4期232-234,共3页Journal of Clinical Stomatology

摘　　要：目的:探讨基于3D打印技术制备的个性化重建钛板在髂骨移植修复下颌骨缺损中的应用效果。方法:对6例拟进行下颌骨节段切除的病人,应用3D打印技术打印出下颌骨的树脂模型,制备个性化重建钛板桥接骨缺损两端,并切取髂骨植入骨缺损区,钛钉内固定。术后通过临床检查及X线和CT检查,观察患者的面部外形和咬合关系恢复情况,以及伤口愈合和移植骨成活情况。结果:在6例病例中有5例手术顺利,植入的钛板与缺损两端的下颌骨外侧面贴合紧密;术后随访3~12个月,经临床和CT检查未见肿瘤复发。颌面部外形恢复良好,余留牙咬合关系恢复良好。1例术后3周出现伤口感染,植骨失败。结论:应用3D打印技术预成型的重建钛板联合髂骨移植适用于下颌骨外侧面出现瘤性隆起或破坏的下颌骨肿瘤切除术后的缺损修复。Objective：To evaluate the application and clinical outcomes of mandilbular defect reconstruction after surgical excision of mandibular tumors by using the computer-assisted pre-bent individual reconstruction plate and nonvascularized iliac crest bone graft. Methods ： Six patients with mandibular defect after surgical excision of mandibular tumors were selected. 3-dimensional individual stereo mandibular model based on mirror images of the unaffected mandible was obtained to fabricate an anatomically reconstruction plate by using computer-assisted design and manufacturing. The individual reconstruction plate was implanted in the mandibular defect district and fixed onto the remaining mandibular segments after surgical excision of mandibular tumors, and nonvascularized iliac crest bone were inserted into the defect and fixed onto the reconstruction plate. The results of contour and function, complication of recipient and donor sites were analyzed according to the clinical data and follow-up. Results：Five patients had bone grafts survived completely and satisfied with their postoperative facial symmetry and occluding relation. One of the 6 patients had bone graft lost because of infection. Conclusion ： Mandibular defect reconstruction after surgical excision of mandibular tumors by using the computer-assisted pre-bent individual recon- struction plate and nonvascularized iliac crest bone graft can result in successful clinical outcomes.

关 键 词：3D打印 下颌骨缺损 重建钛板 髂骨移植 整复 

分 类 号：R782.2[医药卫生—口腔医学]