计算机辅助技术应用下颌骨缺损修复术后对颞下颌关节间隙的评估  

Evaluation of the temporomandibular joint space after mandibular reconstruction by computer aided technique

作　　者：袁仕廷 任仪鹏[1] 庞恋苏 杨舸[1] 陶冶[1] 温伟生[1] 

机构地区：[1]解放军总医院口腔科,硕士生北京100853

出　　处：《口腔颌面修复学杂志》2018年第1期5-9,共5页Chinese Journal of Prosthodontics

基　　金：解放军总医院临床科研扶持基金(项目编号:2017FC-TSYS-2015)

摘　　要：目的:探讨计算机辅助技术在下颌骨重建修复术后颞下颌关节结构间隙的影响。方法:选取2014年1月至2017年11月因下颌骨肿瘤于解放军总医院口腔科行病变切除后颌骨重建手术患者26例,其中8例患者应用计算机辅助技术指导完成下颌骨重建(数字化重建组),18例患者传统手术方式行下颌骨重建(对照组),所有患者术前及术后均行颌面部三维螺旋CT检查,应用Mimics19.0软件测量术前、术后颞下颌关节间隙,计算线性比例,使用SPSS 17.0软件包对测量数据进行统计学处理。结果:数字化重建组术前、术后颞下颌关节上间隙、后间隙及髁突横轴与正中线的夹角均差异无统计学意义(P>0.05),关节前间隙差异有统计学意义(P<0.05)。对照组颞下颌关节前、上、后间隙及髁突横轴与正中线的夹角差异有统计学意义(P<0.05)。数字化重建组与对照组2组间术前各测量值差异均无统计学意义(P>0.05);术后前间隙差异无统计学意义(P>0.05),上间隙、后间隙及夹角差异有统计学意义(P<0.05)。术前2组髁突均位于中位,术后两组间髁突位置变化差异无统计学意义(P>0.05),其中数字化重建组有1例(12.5%)关节前移位,对照组有6例(33%)关节前移位。结论:计算机辅助技术应用于下颌骨缺损的重建修复能够有效提高手术的可预见性,更好恢复下颌骨形态及髁突的三维位置关系,提高重建效果。Objective： To explore the influence of the structural of the temporomandibular joint after mandible reconstruction by computer aided technology. Methods： OF twenty-four patients were admitted from from January 2014 to November 2017 who underwent mandible reconstruction because of the mandibular tumor in our hospital, Eight patients surgically reconstruction by computer aided technical （digital reconstruction group）, and 18 patients surgically reconstruc- tion by traditional methods （control group）, all patients with maxillofacial three-dimensiona! spiral CT examination pre - and postoperative, Temporomandibular joint space and linear ratio were calculated pre - and postoperative with the Mimics 19.0 software, statistical analysis was performed using SPSS 17.0 software package. Results： There was no significant dif- ference of anterior and posterior temporomandibular joint space, angle between the condyle transverse axis and the median line in the digital reconstruction group（P〉0.05）, but statistical difference of the anterior joint space （P〈0.05）. There was statistically significant difference in the control group （P〈0.05）. There was no statistically significant difference of preoperative joint space between the two groups（P〉0.05）, After the operation, there was no statistical significance in the anterior joint space （P〉 0.05）, but significant difference of post-operative superior and posterior temporomandibular joint space（P〈0.05）. There was no preoperative condyle displacement between the two groups and no statistical significance of post-operative condylar position（P〉0.05）. There were 1 cases （12.5%） of post-operative with anterior transposition of the joint in the digital reconstruction group, but 6 cases （33%） in the control group. Conclusions： Computer aided technology can effectively improve the predictability of the surgical procedure in the reconstruction of mandibular defects, precise restoration the mandible morphology and condylar posit

关 键 词：计算机辅助技术 颞下颌关节 下颌骨 修复重建 

分 类 号：R782.6[医药卫生—口腔医学]