三维打印技术联合多功能[牙合]板治疗儿童下颌骨骨折初探  

Preliminary study on treatment of mandibular fracture in children with three-dimensional printing technology combined with multifunctional occlusal splint

作　　者：张晨晨 宋驰 杨东昆[1] 李珍珍 王栋 高廷益[1] 胡洁 张凯[1] Zhang Chenchen;Song Chi;Yang Dongkun;Li Zhenzhen;Wang Dong;Gao Tingyi;Hu Jie;Zhang Kai(Department of Stomatology,The First Affiliated Hospital of Bengbu Medical College Stomatology,Bengbu 233000,China)

机构地区：[1]蚌埠医学院第一附属医院口腔科,蚌埠233000

出　　处：《中华口腔医学杂志》2023年第11期1172-1177,共6页Chinese Journal of Stomatology

基　　金：2021年高校学科(专业)拔尖人才学术资助项目(gxbjZD2021058)。

摘　　要：目的探讨三维打印技术与多功能[牙合]板在儿童下颌骨骨折治疗中的作用。方法回顾性纳入2006年1月至2022年1月就诊于蚌埠医学院第一附属医院口腔科,采用手术治疗的儿童下颌骨骨折患者42例,其中男性25例,女性17例,中位年龄10岁(4~12岁)。按照治疗方式分为观察组(22例)和常规组(20例)。观察组通过术前制作多功能[牙合]板,并将患者的CT数据以".dicom"格式导入Mimics软件,对移位的下颌骨进行虚拟复位,应用三维打印技术制作颌骨复位模型,在复位模型上模拟手术操作,确定内固定装置的型号与位置并塑形,术中按术前设计行骨折的复位、固定。常规组采用传统方法行下颌骨骨折切开复位内固定术。通过比较两组患者术中情况、咬合关系及随访情况,分析三维打印技术与多功能[牙合]板的临床应用价值。结果观察组的术中总出血量[(30.25±4.02)ml]和手术时间[(64.3±9.2)min]均显著少于常规组[分别为(35.13±5.69)ml和(84.6±13.9)min](F=6.18,P=0.003;F=1.32,P=0.001)。观察组的咬合关系优良率[96%(21/22)]显著高于常规组[85%(17/20)](F=4.27,P=0.039)。术后并发症的发生情况,观察组1例咬合关系欠佳,1例术后感染;常规组3例咬合关系欠佳,1例神经损伤,牙根、牙胚损伤各1例。结论三维打印技术联合多功能[牙合]板应用于儿童下颌骨骨折,具有微创、安全、高效、精准的作用,临床效果良好。Objective To explore the role of digital three-dimensional printing technology and multifunctional occlusal splint in the treatment of mandibular fracture in children.Methods From January 2006 to January 2022,42 children with mandibular fracture were treated by Department of Stomatology,in The First Affiliated Hospital of Bengbu Medical College,including 25 males and 17 females.The patients,aged from 4 to 12 years,with the median age was 10 years old,were divided into observation group(22 cases)and routine group(20 cases)according to the treatment methods.In the observation group,the multifunctional occlusal splint was made before operation,and the CT data of the children were imported into Mimics software in".dicom"format,and the displaced mandible was virtually reset.The jaw reduction model was made by three-dimensional printing,and the surgical operation was simulated on the reduction model to determine the model and position of the internal fixation device and shape it.During the operation,the fracture was reduced and fixed according to the preoperative design.The conventional group was treated with open reduction and internal fixation of mandibular fracture by traditional methods,and the clinical application value was compared and analyzed through the intraoperative situation,occlusal relationship,and follow-up of the two groups.Results The total intraoperative bleeding volume[(30.25±4.02)ml]and surgical time[(64.3±9.2)min]in the observation group were significantly lower than those in the conventional group[(35.13±5.69)ml and(84.6±13.9)min,respectively](F=6.18,P=0.003;F=1.32,P=0.001).The excellent and good rate of occlusal relationship in the observation group[96%(21/22)]was significantly higher than that in the conventional group[85%(17/20)](F=4.27,P=0.039).The incidence of complications,the observation group,1 case of poor occlusion,1 case of postoperative infection;In the routine group,there were 3 cases with poor occlusion,1 case with nerve injury,1 case with root injury and 1 case with tooth germ i

关 键 词：儿童 下颌骨折 数字化 三维打印 手术治疗 

分 类 号：R782.4[医药卫生—口腔医学]