计算机辅助设计与3D打印导板在下颌角成形术中的应用  

Application of Computer-aided Design and 3D Printing Template in Mandibular Angloplasty

作　　者：杨运强[1] 顾旖菲 邵乐南[1] 汤国雄[1] 蒋梁[1] 李殿奇 张广[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院口腔科,武汉430030 [2]四川大学华西口腔医院口腔颌面外科,成都610041

出　　处：《华中科技大学学报（医学版）》2017年第3期317-321,共5页Acta Medicinae Universitatis Scientiae et Technologiae Huazhong

基　　金：国家自然科学基金青年科学基金资助项目(No.81500830)

摘　　要：目的介绍并探讨计算机辅助设计(CAD)与3D打印技术在下颌角成形术中的应用价值,以期优化手术模式与获得最佳整形美容效果。方法对来自四川大学华西口腔医院颌面外科与华中科技大学同济医院口腔科就诊的16例方脸患者术前拍摄头颅CBCT并进行三维数据重建,通过计算机辅助设计确定个性化下颌角截骨范围,用3D打印技术制作下颌骨模型,并制作实施准确手术的导板。在手术中用此导板引导进行下颌骨的"V-line"弧线截骨,部分患者同时结合颧骨颧弓与颏部的面部轮廓整形手术,术后效果通过3D曲线函数来评估。结果所有患者术后均对自己面型满意,术后下颌骨两侧几乎完全对称,X线显示截骨线流畅平滑,完全达到术前设计要求。结论计算机辅助设计与3D打印技术的有机结合为下颌角成形术的准确性、安全性与可预见性提供了新策略与新方法。数字化下颌角成形术的应用不仅提高了美容效果,而且能减少手术时间,降低手术难度并降低损伤重要神经血管的风险,值得临床推广应用。Objective To introduce and discuss the application value of digital image manipulation combined with 3-dimensional（3D）printed template in mandibular angloplasty,so as to optimize the surgical technique model and achieve the best cosmetic effect.Methods Sixteen patients from Department of Oral and Maxillofacial Surgery,West China Hospital of Stomatology of Sichuan University,and Department of Stomatology,Tongji Hospital of Huazhong University of Science and Technology were enrolled in this study.All of the patients received pre-surgical CBCT scans,underwent 3Ddata reconstruction,and then personalization scope of mandibular angle osteotomy was determined through the computer-aided design（CAD）.We then fabricated the mandible model and surgical template for accurate operation using 3Dprinting technique.Mandibular angle V-line osteotomy were carried out under the guidance of this template during operation and some patients were additionally treated with reduction malarplasty and genioplasty.The cosmetic effect was evaluted through 3Dcurve function.Results All patients were satisfied with their cosmetic outcomes.The bilateral sides of the mandible were almost completely symmetrical.The X-ray indicated the cutting line was smooth and fluent and the outcomes completely achieved the pre-surgical requirement. ConclusionThe combination of computer-aided design and 3Dprinting technique can provide new strategy and method for accuracy,safety,predictability of mandibular angloplasty.The digital mandibular angloplasty can not only improve the cosmetic effect,but also decrease the surgical time,reduce the operation difficulty and lower the risk of injury of important vessels and nerves,and it should be worthy of clinical application.

关 键 词：下颌角成形术 计算机辅助设计 手术导板 3D打印技术 

分 类 号：R319.1[医药卫生—基础医学]