计算机虚拟设计与3D打印技术在儿童下颌骨骨折治疗中的应用  

Feasibility analysis of computer virtual design and 3D printing technology in the treatment of pediatric mandibular fracture

作　　者：吕德馨 单培芬 李良 林思思[1] 聂鑫 Lyu Dexin;Shan Peifen;Li Liang;Lin Sisi;Nie Xin(School and Hospital of Stomatology,Wenzhou Medical University,Wenzhou,Zhejiang 325000,China;3D Digital Medical Research and Transformation Center,Wenzhou Medical University,Wenzhou,Zhejiang 325000,China)

机构地区：[1]温州医科大学附属口腔医院,浙江温州325000 [2]温州医科大学3D数字医疗研究与转化中心,浙江温州325000

出　　处：《创伤外科杂志》2021年第12期905-910,共6页Journal of Traumatic Surgery

摘　　要：目的分析计算机虚拟设计与3D打印应用于儿童下颌骨骨折治疗的可行性。方法回顾性分析2018年1月—2020年1月温州医科大学附属口腔医院收治的下颌骨骨折儿童患者33例,男性20例,女性13例;年龄2~12岁,平均6.9岁。按照患者自愿原则分为3D组(18例)和常规组(15例)。3D组通过计算机虚拟设计与3D打印制备颌骨损伤模型、术后复位模型及咬合导板,按预定位置行下颌骨骨折固位;常规组采用小型内固定器械实现骨折坚固内固定。两组患者同时采用牙间结扎进行加强。3D组男性11例,女性7例;年龄2~12岁,平均6.7岁;单发骨折13例,多发骨折5例;摔伤6例,道路交通伤5例,高处坠落伤4例,运动伤2例,其他1例。常规组男性9例,女性6例;年龄3~11岁,平均7.1岁;单发骨折12例,多发骨折3例;摔伤7例,道路交通伤6例,高处坠落伤2例。通过两组患者术中情况、患者满意度、术后不良反应(主要表现为发热和肿胀)及随访情况比较分析临床应用价值及术后牙胚发育情况。结果3D组术中总出血量(28.6±7.5)mL少于对照组(30.2±8.9)mL(P>0.05),术后不良反应发生率比较差异无统计学意义(P>0.05);3D组平均总手术时长(65.3±11.8)min显著少于常规组(83.2±14.7)min(P<0.05);3D组术后满意度(8.9±1.0)分显著高于常规组(7.9±1.8)分(P<0.05)。结论运用计算机虚拟设计及3D打印技术,能有效减少儿童下颌骨手术时长,提高患者术后满意度,有利于骨折的精确复位并降低对牙胚的影响,有一定的临床应用价值。Objective To explore the feasibility of computer virtual design and 3D printing technology in the treatment of pediatric mandibular fracture.Methods A retrospective analysis was conducted in 33 cases of mandibular fractures admitted to the School and Hospital of Stomatology,Wenzhou Medical University from Jan.2018 to Jan.2020.There were 20 males and 13 females,with an average age of 6.9years(range,2-12years).The children with mandibular fractures were divided into 3D(18 cases)and conventional groups(15 cases)according to their own wish.In 3D group,the mandibular fracture fixation was performed according to the predetermined position by preparing the mandibular fracture reduction model and occlusal guide plate through computer virtual design and 3D printing.In the conventional group,small internal fixation devices were used to achieve solid internal fixation of the fracture,while interdental ligation was used for reinforcement in both groups.In the 3D group,there were 11 males and 7 females,with an average age of 6.7 years(range,2-12 years);13 cases of single fractures,5 cases of multiple fractures;6 cases of falling injuries,5 cases of traffic injuries,4 cases of falls from height,2 cases of sports injuries,and other reason in 1 case.In the conventional group,there were 9 males and 6 females,with an average age of 7.1 years(range,3-11 years);12 cases of single fractures,3 cases of multiple fractures;7 cases of falling injuries,6 cases of traffic injuries,2 cases of falls from height.The clinical application value and the development of dental embryo after surgery were compared and analyzed by the intraoperative situation,patient satisfaction,postoperative adverse reactions and follow-up of the two groups.Results The total intraoperative blood loss in the group(28.6±7.5)mL was less than that in the control group(30.2±8.9)mL(P>0.05).There was no significant difference in the intraoperative blood loss and postoperative incidence of adverse events between the two groups(P>0.05).The operative time of the 3D group(65

关 键 词：下颌骨骨折 牙胚 虚拟设计 3D打印 儿童 

分 类 号：R683[医药卫生—骨科学]