三维打印精准手术导板与传统咬合导板在偏颌畸形治疗中的对比研究  

The comparison of 3D printing surgical guide and traditional occlusal splint in the treatment with facial asymmetry cases

作　　者：蔡鸣[1] 杨育生[1] 王旭东[1] 李彪[1] 沈舜尧[1] 姜腾飞[1] 沈国芳[1] Cai Ming;Yang Yusheng;Wang Xudong;Li Biao;Shen Shunyao;Jiang Tengfei;Shen Guofang(Department of Oral ＆ Craniomaxillofacial Surgery, Shanghai Ninth People＇s Hospital, Shanghai Jiaotong University, School of Medicine,Shanghai 200011 ,China)

机构地区：[1]上海交通大学医学院附属第九人民医院口腔颅颌面科,上海市口腔医学重点实验室,200011

出　　处：《中华整形外科杂志》2018年第6期417-421,共5页Chinese Journal of Plastic Surgery

基　　金：国家自然科学基金（81470786）

摘　　要：目的对比三维打印个性化精准手术导板与传统咬合导板，在正颌正畸治疗偏颌畸形中的疗效与精度。方法选取12例需正颌正畸治疗偏颌畸形的患者，6例为三维设计组，于术前进行颌骨CT扫描与牙齿激光扫描建立数字模型，设计双颌加颏成形术、上颌骨LeFortI型截骨术，并三维打印颏成形术截骨与定位导板；另6例为传统手术组，采用传统的咬合导板进行正颌手术。术后行CT检查进行三维测量，并与手术规划比较分析。结果三维设计组术后结果与手术规划相比，上颌骨最大误差为0．65mm，平均误差小于1mm。传统手术组术后结果与手术规划相比，上颌骨最大误差为2．11mm，平均误差大于1mm。2组平均误差相比，差异具有统计学意义（P〈0．05）。结论三维打印精准手术导板可以提供精准的截骨位置并控制颌骨移动，相比传统咬合导板，有效提高了偏颌畸形患者正颌手术精度。Objective To compare the surgical accuracy of the 3D printing surgical guide and traditional occlusal splint in the treatment of skeletal facial asymmetry cases. Methods 12 facial asymmetric patients underwent joint orthognathic and orthodontics treatments were included in this research. In the 3D printing group （n =6） the pre-surgical CT scan for the skeleton and laser scan for the dentures were performed and 3D orthognathic procedures including Le Fort ] and BSSRO combined with genioplasty were planned. The 3D printing surgical guides were manufactured and applied during surgeries. Another 6 cases were received same procedures by traditional occlusal splint techniques as the control group. Post-surgical CT reconstruction and 3D superimposition with pre-surgical planning was carried out for outcome comparison. Results The maximal error of maxillar was 0. 65 mm and average error was less than 1 mm in 3D printing group, while the maxillary maximal error was 2.11 mm and average error was greater than 1 mm in traditional group which showed the statistical significance （ P 〈 0. 05 ）. Conclusions The usage of 3D printing surgical guide could improve the orthognathic surgical precision by controlling the jaw bone in a three-dimensional way.

关 键 词：三维打印 模型外科 颌导板 正颌外科学 

分 类 号：R783.5[医药卫生—口腔医学]