数字化技术用于25例患者正颌手术效果评价  

Evaluation of digital technology for orthognathic surgery in 25 patients

作　　者：李莉[1,2] 孙健[1,2,3] 李亚莉 陈立强[1,2] 陈晨[1,2] 王硕[1] 王志浩[1,2] 孟坤[1,2] 孙鸣 张秀秀 LI Li;SUN Jian;LI Ya-li;CHEN Liqiang;CHEN Chen;WANG Shuo;WANG Zhi-hao;MENG Kun;SUN Ming;ZHANG Xiu-xiu(Department of Oral and Maxillofacial Surgery,Qingdao University Affiliated Hospital,Qingdao 266000;School of Stomatology of Qingdao University,Qingdao 266000;Oral Digital Medicine and 3-Dimensional Printing Engineering Lab oratory,Qingdao 266000,Shandong Province,China)

机构地区：[1]青岛大学附属医院口腔颌面外科,山东青岛266000 [2]青岛大学口腔医学院,山东青岛266000 [3]青岛市口腔数字医学与3D打印工程实验室,山东青岛266000

出　　处：《上海口腔医学》2021年第2期219-224,共6页Shanghai Journal of Stomatology

基　　金：山东省科技发展计划项目(2014GSF118108)。

摘　　要：目的:应用数字化技术辅助正颌外科三维重建测量、术前诊断、手术设计与模拟、导板制作、导航验证和效果评估,探索制订更加科学、合理的数字化诊治方法和流程。方法:选取25例先天性牙颌面畸形患者,术前行颅颌面CT扫描,将CT数据导入Mimics 20.0软件,建立数字化原始模型。确定三维重建测量硬组织标志点并进行测量、分析、诊断、手术方案设计和导板制作。术中采用手术导航系统,进行上颌骨设计位置的确认、固位验证和骨打磨精确导引。术后1周复查颅颌面CT,并进行设计方案的术后验证。采用SPSS 24.0软件包对数据进行统计学分析。结果:25例患者均按照数字化正颌外科设计及流程完成手术,术后效果达到术前设计方案的要求。术后实际数字化三维重建头模与术前预测头模相比,10个骨性标志点在X、Y、Z三维方向上均无统计学差异(P>0.05)。结论:采用数字化技术辅助正颌外科诊断、手术设计和实施具有精准、微创的优越性。PURPOSE: To use three-dimensional reconstruction measurement, preoperative diagnosis, surgical design,surgical simulation, guide plate production, navigation verification and effect evaluation of orthognathic surgery assisted by digital technology, in order to explore more scientific and reasonable programs and procedures of orthognathic surgery.METHODS: Twenty-five patients with congenital dental and maxillofacial deformity were selected as the experimental subjects, craniofacial spiral CT was conducted before surgery and CT data were imported into Mimics 20.0 software to es-tablish a 3 D head digital model. The bone landmarks in three-dimensional reconstruction digital model were selected,measured, analyzed and diagnosed, and the design of the surgical plan and the production of the guide plates were performed. Surgical navigation system was used to confirm the maxillary position, verify the bone retention and guide precise bone grinding during operation. Craniofacial spiral CT was conducted 1 week after surgery for postoperative validation of the surgical design protocol. Statistical analysis was performed using SPSS 24.0 software package. RESULTS: All 25 patients were operated according to the digital orthognathic surgery design and procedure.There were no significant differences in X, Y and Z three-dimensional directions in 10 actual landmarks between the postoperative actual head model and the preoperative predictive head model(P>0.05). CONCLUSIONS: Orthognathic surgery assisted by digital technology has the advantages of precision and minimal invasiveness.

关 键 词：数字化技术 正颌手术 手术导航 

分 类 号：R782.2[医药卫生—口腔医学]