数字化咬合板与传统咬合板在正颌手术中定位上颌骨的精确性临床研究  

Clinical research on the accuracy of digital occlusal splint and traditional occlusal splint in locating maxillary in orthognathic surgery

作　　者：胡利 程烨 李贵凤[1] 孙卫斌[1] 朱锋 HU Li;CHENG Ye;LI Gui-Feng;SUN Wei-bin;ZHU Feng(Nanjing Stomatological Hospital,Medical School of Nanjing University,Jiangsu Nanjing 210008,China;The Fourth Afiliated Hospital of Nanjing Medical University,JiangsuNanjing 210031,China)

机构地区：[1]南京大学医学院附属口腔医院,苏南京210008 [2]南京医科大学第四附属医院,江苏南京210031

出　　处：《临床口腔医学杂志》2023年第4期228-232,共5页Journal of Clinical Stomatology

摘　　要：目的:通过临床研究分析数字化咬合板与传统咬合板在正颌手术中定位上颌骨的精确性。方法:回顾性收集2017~2022年就诊于南京大学医学院附属口腔医院的成年骨性错(牙合)畸形患者,筛选具有完善术前术后影像学CT数据、牙列模型数据且已完成双颌正颌手术的病例18例,其中8例通过传统咬合板辅助正颌手术,10例通过数字化咬合板辅助正颌手术。根据患者术前术后影像学资料及牙列数据通过Mimics Research 20.0及3-matic Research 12.0软件完成颅骨模型重建以及牙列模型数据的替换,完成正颌手术术前、术后三维(冠状位,矢状位,轴位)方向上实际移动距离的测量。测量三维方向上术前预计移动距离与术后实际移动距离的线性差异。结果:传统咬合板组术前计划与术后实际移动平均线性差为(1.00±0.32)mm;数字化咬合板组术前计划与术后实际移动平均线性差为(0.99±0.38)mm。两种咬合板对指导正颌手术中上颌骨的三维方向的定位无显著差异。结论:数字化咬合板与传统咬合板的使用均可在正颌手术中准确定位上颌骨。Objective:Through clinical research analysis the accuracy of digital occlusal splint and traditional occlusal splint in locating the maxillary in orthognathic surgery.Methods:The adult patients with skeletal malocclusion who were treated in the Affiliated Stomatological Hospital of Nanjing University Medical College from 2017 to 2022 were retrospectively collected,a total of 18 patients with complete preoperative and postoperative imaging CT data,dental model data,and complete orthognathic surgery were screened.Of which 8 cases were assisted with orthognathic surgery by traditional occlusal splint,and 10 cases were assisted with orthognathic surgery by digital occlusal splint.According to the preoperative and postoperative imaging data and dentition data of patients,the skull model reconstruction and the replacement of dentition model data were completed by using Mimics Research 20.0 and 3-matic Research 12.0 software,and the measurement of the actual movement distance in the three-dimensional(coronal,sagittal,axial)directions before and after orthognathic surgery was completed.The linear difference between the predicted preoperative movement distance and the actual postoperative movement distance in the three-dimensional direction of orthognathic surgery were measured.Results:The average linear difference between planned motion and acquired motion in the traditional occlusal splint group was(1.00+0.32)mm,between planned and acquired motion in the digital occlusal splint group was(0.99+0.38)mm.There was no significant difference between the two kinds of occlusal splints in guiding the three-dimensional orientation of the maxilla in orthognathic surgery.Conclusion:The use of digital occlusal splint and traditional occlusal splint can accurately locate the maxillary bone in orthognathic surgery.

关 键 词：正颌手术 咬合板 精确性 虚拟手术计划 传统手术计划 

分 类 号：R782.2[医药卫生—口腔医学]