计算机辅助游离腓骨下颌骨重建的术后效果评估  

Evaluation of the postoperative effect of computer-assisted free fibula mandibular reconstruction

作　　者：康泽标 买晓雪 王鑫 谢富强[1,2] Kang Zebiao;Mai Xiaoxue;Wang Xin;Xie Fuqiang(Dept.of Oral and Maxillofacial Surgery,School of Stomatology Lanzhou University,Lanzhou 730000,China;Dept.of Stomatology,Lanzhou University Second Hospital,Lanzhou 730000,China)

机构地区：[1]兰州大学口腔医学院口腔颌面外科教研室,兰州730000 [2]兰州大学第二医院口腔科,兰州730000

出　　处：《华西口腔医学杂志》2022年第2期189-196,共8页West China Journal of Stomatology

基　　金：甘肃省科技厅自然科学基金项目(20JR10RA737)。

摘　　要：目的建立一种标准化、可重复、简易的数字化评估方法,精确评估计算机辅助游离腓骨下颌骨重建术后效果。方法通过对20例因肿瘤致下颌骨缺损后行计算机辅助游离腓骨下颌骨重建手术病例的回顾性分析,在Mimics Research 21.0及3-matic Research 13.0软件辅助下对重建术前与术后冠状向、矢状向与轴向下颌角进行测量分析,评估计算机辅助游离腓骨下颌骨重建术后效果。结果在计算机辅助游离腓骨下颌骨重建的20例患者中,术前健侧和患侧冠状下颌角、轴向下颌角差异无统计学意义(P>0.05),矢状下颌角差异有统计学意义(P<0.05);术后健侧和患侧冠状、矢状、轴向下颌角差异均无统计学意义(P>0.05)。术前与术后健侧和患侧冠状、矢状、轴向下颌角差值的绝对值差异有统计学意义(P<0.01)。Ⅰ类缺损术前健侧和患侧矢状下颌角、术后健侧和患侧轴向下颌角差异有统计学意义(P<0.05),其余各类缺损术前与术后健侧和患侧三维下颌角差异均无统计学意义(P>0.05)。Ⅰ类缺损术前与术后健侧和患侧矢状、冠状下颌角差值的绝对值差异无统计学意义(P>0.05),其余各类缺损术前与术后健侧和患侧三维下颌角差值的绝对值差异均有统计学意义(P<0.05)。结论计算机辅助游离腓骨下颌骨重建对于肿瘤造成的三维方向的颌骨畸形均有显著的改善,能有效恢复下颌骨解剖结构的精确对称,应用本研究的评估方法能精确地评估下颌骨重建术后效果,为术前的设计提供指导。Objective This study aims to establish a standardized,repeatable,and simple digital evaluation method for accurately determining the effect of computer-assisted free fibula mandibular reconstruction.Methods A total of 20mandibular defect cases caused by tumors were analyzed retrospectively.The coronal,sagittal,and axial mandibular angles were measured and analyzed with Mimics Research 21.0 and 3-matic Research 13.0 software before and after surgery.The effect of computer-assisted free fibula mandibular reconstruction was evaluated.Results No significant difference was observed in the coronal and axial mandibular angles between the healthy and affected sides before operation(P>0.05).By contrast,a significant difference in sagittal mandibular angle(P<0.05)was noted.No significant difference was found in the coronal,sagittal,and axial mandibular angles between the healthy and affected sides after operation(P>0.05).Conversely,a significant difference was recorded in the absolute value of the coronal,sagittal,and axial mandibular angles between the healthy and affected sides pre-operation and post-operation(P<0.01).Meanwhile,a significant difference was observed in the sagittal mandibular angle between the healthy and affected sides before operation and the axial mandibular angle between the healthy and affected sides after operation in TypeⅠdefect(P<0.05).Moreover,no significant difference in the 3 D mandibular angle was found between the healthy and affected sides before and after operation in other types(P>0.05).Furthermore,no significant difference was recorded in the absolute values of the sagittal and coronal mandibular angles between the healthy and affected sides before and after operation in TypeⅠdefect(P>0.05).Lastly,a significant difference was found in the absolute values of the 3 D mandibular angles between the healthy and affected sides before and after operation in other types(P<0.05).Conclusion Computerassisted free fibula mandibular reconstruction can significantly improve 3 D mandibular deformiti

关 键 词：下颌骨重建 计算机辅助手术 精确度 游离腓骨皮瓣 

分 类 号：R782.05[医药卫生—口腔医学]