数字化导板在手术优先正颌外科中应用的初步探讨  

Application of Three Dimensional Printing Digital Guide Plate in Surgery-First-Orthodontic-Approach for Mandibular Asymmetry

作　　者：黄跃[1] 林李嵩[1] 黄建平[1] 施斌[1] 黄立[1] 江燕[1] HUANG Yue;LIN Lisong;HUANG Jianping;SHI Bin;HUANG Li;JIANG Yan(Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, China)

机构地区：[1]福建医科大学附属第一医院口腔颌面外科

出　　处：《福建医科大学学报》2019年第6期422-426,共5页Journal of Fujian Medical University

基　　金：福建省卫计委医学创新课题(2018-CX-27)

摘　　要：目的探讨三维打印技术制作的数字化导板用于“手术优先”指导矫正下颌骨不对称畸形的可行性。方法6例下颌骨不对称畸形患者均进行全头颅三维螺旋CT扫描,将患者的石膏模型扫描数据在Proplan CMF 3.0与头颅CT数据进行拟合。通过该软件对头颅模型进行上下颌的截骨、骨块移动,收集并输出数据,经快速原型机打印形成三维导板。术中先利用三维打印数字化导板进行骨块移动和固定,后应用传统导板检验骨块的新位置,验证三维打印数字化导板的临床实用性。术后3月评估手术效果。结果5例患者术前建立的三维打印数字化导板能起到引导手术、预测手术效果的作用。术后3月随访,患者对外形满意。结论三维打印数字化导板可以有效引导手术过程,有望代替传统模型外科在牙颌面畸形的作用,为下颌骨不对称畸形的“手术优先”治疗模式提供合理参考。Objective To study the feasibility on three dimensional printing guide plate in surgery-first-orthodontic-approach for maxillofacial asymmetry and to evaluate the effect.Methods 6 patients with dento-mandibular deformities underwent spiral CT scan to collect raw data and laser scan for the dentures were performed.The data from CT scan and laser scan were imported into ProPlan CMF software.The preoperative planning including segmentation,osteotomies,and movements of the jaw bones was simulated using the ProPlan CMF.The digital guide plates were fabricated by three dimensional printing.The model surgery for each patient was performed at the same time and the traditional surgical plates were made.Two kinds of plates were brought to the operating room during the surgery to compare the two methods of preoperative planning and fabrication of the plates.Results Most of the three dimensional printing digital guide plate worked well with mandibular surgery.5 patients were shown to be good for predicting the effect of surgery.The 3-month follow-up results showed the patients were satisfied with their appearance and had no complications including TMJ disorder.Conclusion Three dimensional printing digital guide plate is valuable in precisely simulating osteotomy,contributing to understand surgery-first-orthodontic-approach for mandibular asymmetrical patients.

关 键 词：生物医学工程 颌/外科学 口腔 下颌骨 先天畸形 正畸学 矫正 

分 类 号：R782.2[医药卫生—口腔医学]