数字化技术结合导板在下颌骨粉碎性骨折复位内固定术中的应用  

Application of digital technology combined with guide plate in the internal fixation of mandibular comminuted fracture

作　　者：应凯 王亮 朱永武 毛斌 李倩倩 Ying Kai;Wang Liang;Zhu Yongwu;Mao Bin;Li Qianqian(Department of Stomatology,Yongkang first people’s Hospital Medical Group,Yongkang 321300)

机构地区：[1]永康市第一人民医院口腔科,永康321300

出　　处：《口腔材料器械杂志》2022年第3期225-228,共4页Chinese Journal of Dental Materials and Devices

摘　　要：目的探讨数字化技术、3D打印模型结合导板在下颌骨粉碎性骨折中的应用。方法选取下颌骨粉碎性骨折患者19例,进行1.0 mm层厚三维CT扫描,数据通过DICOM格式导出,利用软件进行虚拟手术复位骨折,复位后3D打印出下颌骨模型及咬合导板。在下颌骨模型上进行钛板预弯及制作复位导板,术中引导骨折块复位固定。结果术后19例患者手术切口均无感染征,创口隐蔽美观,骨折对位精确,钛板与骨折段贴合;术后6月随访骨折对位愈合情况好,无明显移位。患者下颌无偏斜,无张口、咬合疼痛,咬颌关系良好,未见明显张口受限。结论数字化技术、3D打印模型结合导板能让下颌骨粉碎性骨折精确复位,简化手术过程,是一种精准、可预测的手术辅助方式。Objective The aim of this study was to investigate the clinical application experience of digital technology combined with guide plate and 3D printing model in the reduction and internal fixation of mandibular comminuted fracture.Methods A total of 19 patients with mandibular comminuted fracture were recruited,and they were examined by 3D CT scanning with 1.0 mm thickness.CT data were exported to a file with DICOM format.Using the DICOM Viewer,a virtual surgery was performed to reduce the fracture,and after the reduction,3D printing of mandible model and occlusal guide plate was conducted.Pre-bending the titanium plate and preparation of the reduction guide were performed on the mandible model,which guided the reduction and fixation of the fracture during the surgery.Results No signs of postoperative infection in the surgical incisions were found in all 19 cases,and the incisions were hidden and beautiful.The fracture was accurately aligned,and the titanium plate well fitted the fractured segment.The follow-up at postoperative 6 months showed that the fracture healing was good without obvious displacement.Deflection of the mandible,and pain in opening mouth and biting were not detected.The bite-jaw relationship was good,and no obvious restriction of jaw opening was examined.Conclusion Digital technology combined with guide plate and 3D printing model contributes to an accurate reset of mandibular comminuted fracture,which is a simple,accurate and predictable auxiliary method of surgery.

关 键 词：下颌骨粉碎性骨折 数字化技术 导板 3D打印 

分 类 号：R782.4[医药卫生—口腔医学]