数字化外科技术辅助下颌骨陈旧性骨折复位重建的临床应用  

The Clinical Application in the Reconstruction of Old Mandible Fracture with Digital Surgical Technique

作　　者：明华伟[1] 何芸[1] 周翊飞 袁宗毅[1] 张兴安[1] 王华东[1] 韩新生 谭小尧[1] MING Hua-wei;HE Yun;ZHOU Yi-fei;YUAN Zong-yi;ZHANG Xing-an;WANG Hua-dong;HAN Xin-sheng;TAN Xiao-yao(Department of Oral and Maxillofacial Surgery,the Second Clinical Medical College of North Sichuan Medical College,Central Hospital of Nanchong,Nanchong 637000,Sichuan,China;Department of Stomatology,Langzhong People’s Hospital,Langzhong 637400,Sichuan,China)

机构地区：[1]川北医学院第二临床医学院·南充市中心医院口腔颌面外科,四川南充637000 [2]阆中市人民医院口腔科,四川阆中637400

出　　处：《中国美容医学》2020年第1期75-78,共4页Chinese Journal of Aesthetic Medicine

基　　金：四川省南充市科技局资助项目(编号:16YFZJ0026);川北医学院科研发展计划项目(编号:CBY16-A-YB43)

摘　　要：目的:探讨数字化外科技术在下颌骨陈旧性骨折复位重建手术中的临床效果。方法:选取2016年3月-2019年3月于笔者科室诊治的下颌骨陈旧性骨折并发咬合关系紊乱、面部畸形患者24例,将颌面部CT扫描获得的影像学数据以DICOM格式导入计算机软件进行分析处理,设计手术方案,再结合3D打印技术制作截骨导板、咬合关系导板及颌骨模型来指导手术操作。对骨折固定可靠效果、面部外形及咬合关系进行临床评价。结果:本组患者术后骨折断端固定可靠,咬合关系恢复理想,面容基本对称。术后随访6~12个月,患者面部畸形显著改善,咬合关系完全矫正,咀嚼效率明显提高,效果满意。结论:数字化外科技术辅助下颌骨陈旧性骨折复位重建手术实现了可视化、精准化的操作流程,是一种精确、高效、可预测的辅助方式。Objective The aim of the study was to assess the clinical effects of digital surgical technique in reconstruction of old mandible fracture.Methods 24 patients who suffered from old mandible fracture with facial deformity and occlusion disorder were selected from March 2016 to March 2019,The preoperative maxillofacial CT scan were performed to obtain the imaging data,which were imported into the computer software with DICOM fomats for analyzing and processing,and the surgical program was designed.Then the bone cutting guide plate,Occlusal guide plate and jaw model were made by combining the 3D printing technology to guide the operation.Evaluated fixation effects,facial appearance and occlusion.Results The facial features of 24 patients were basically symmetrical after the reconstruction of old mandible fracture by surgical guide plate.All patients obtained good results on both postoperative occlusion and restoration of fractures.The patients were followed up from 6 to 12 months,facial deformities were significantly improved,occlusions were completely corrected and the mastication rates were obviously improved.Conclusion With the assistance of digital surgical technology,the reconstruction of old mandible fracture has realized the visualization and precision of operational process,which is an accurate,efficient and predictable auxiliary method.

关 键 词：外科导板 下颌骨骨折 咬合紊乱 面部畸形 3D打印 

分 类 号：R782.2[医药卫生—口腔医学]