骨支持式3D打印导板在上颌骨LeFortⅠ型截骨术中的应用
Application of bone-support guide by three-dimensional printing technique in maxillary LeFortⅠosteotomy
作者：屈振宇, 王茜, 赵岩, 绳兰兰, 马卫东, 曲卫国
Author：Zhenyu Qu, Qian Wang, Yan Zhao, Lanlan Sheng, Weidong Ma, Weiguo Qu
收稿日期：2017-04-20 年卷（期）页码：2018,36(1):60-60-65
期刊名称：华西口腔医学杂志
Journal Name：West China Journal of Stomatology
关键字：3D打印技术,上颌骨,LeFortⅠ型截骨术;,锥形束CT,正颌外科,
Key words：three-dimensional printing technique,maxillary,LeFortⅠ osteotomy;,cone beam computed tomogra-phy,orthognathic surgery,
基金项目：
中文摘要
目的 探讨3D打印技术制作的截骨导板和再定位导板在上颌骨LeFortⅠ型截骨术中的应用效果。方法 选择8例因上颌发育不良行LeFortⅠ型截骨术的的患者为研究对象,所有患者均进行锥形束CT（CBCT）扫描并建立上颌骨三维模型,使用3D打印技术制作上颌骨截骨导板和再定位导板。所有手术均由同一名医生操作,术中使用截骨导板截骨和再定位导板固定上颌骨块。术后复查CBCT,测量6个标志点到3个基准平面的距离,比较术前虚拟手术与实际手术中上颌骨的位移误差,评估其用于正颌术中上颌骨截骨和再固定的准确性。结果 术后所有患者口内切口均Ⅰ期愈合,无明显并发症。位移误差均值最大为1.35 mm,是左上磨牙点到冠状平面的位移误差;标准差最大为0.85,标准误最大为0.30。位移误差均为临床所接受范围。结论 3D打印技术制作的截骨导板和再定位导板有助于安全、准确地完成上颌骨LeFortⅠ截骨术。
英文摘要
ObjectiveThis study aimed to investigate the application of an osteotomy template and a repositioning template manufactured by three-dimensional (3D) printing technique in maxillary LeFortⅠosteotomy.MethodsThe patient group consisted of eight patients with maxillary hypoplasia who underwent LeFortⅠosteotomy. The mean age at the time of surgery was 25.6 years old. All patients were scanned using cone beam computed tomography (CBCT) to create a 3D model of the maxillary. The osteotomy and repositioning templates of the LeFortⅠosteotomy were manufactured by 3D printing technique. All bones were cut by the same doctor with extensive orthognathic surgery experience. One part of the template guided the osteotomy, and the other repositioned the maxilla during operation. Postoperative CBCT scan was performed, and the virtual plan was compared with the postoperative surgical result using an image fusion of the CBCT dataset by analyzing measurements between six landmarks relative to three reference planes. Statistical analysis was performed, and accuracy was reported using SPSS 16.0 software package.ResultsPrimary healing of incisions was observed in all patients, and no serious complications were observed. The maximum mean values were 1.35 mm, and the displacement error was UL6 to the coronal plane. The maximum standard deviation was 0.85, and the maximum standard error was 0.30, which was acceptable by clinical standards.ConclusionThe application of osteotomy and repositioning templates manufactured by 3D printing technique in maxillary LeFortⅠosteotomy was safe and can enable doctors to complete a surgery accurately.
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