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论文摘要

基于钉孔共用理念的数字化导板在口腔颌面外科中的应用

Application of digital guide plate based on drill-hole sharing in oral and maxillofacial surgery

作者:王立冬, 马文, 付帅, 张长彬, 崔庆赢, 彭灿邦, 黎明

Author:Wang Lidong, Ma Wen, Fu Shuai, Zhang Changbin, Cui Qingying, Peng Canbang, Li Ming.

收稿日期:2021-03-31          年卷(期)页码:2022,40(1):68-68-74

期刊名称:华西口腔医学杂志

Journal Name:West China Journal of Stomatology

关键字:数字化手术导板,钉孔共用,计算机辅助技术,三维重建,

Key words:digital surgical guide plate,drill-hole sharing,computer aided technology,three-dimensio-nal reconstruction,

基金项目:云南省应用基础研究(昆医联合专项)[2017FE467(-193)];云南省昆医联合项目—面上项目(202001AY070001-250)

中文摘要

目的探讨基于钉孔共用理念设计的数字化导板在正颌外科及下颌骨重建中的应用效果。方法选择需行正颌手术的16例牙颌面畸形患者和需要下颌骨重建的10例患者为研究对象。对牙颌面畸形患者行颌面部CT扫描和石膏模型激光扫描,下颌骨重建患者行颌面部CT扫描和腓骨或髂骨的CT扫描,并建立三维模型。使用数字化技术基于钉孔共用理念制作截骨和就位导板,术中使用导板引导截骨定位骨块。术后复查CT,测量标志点到3个基准平面的距离及两标志点间的距离,比较术前虚拟手术与实际手术中骨块位移误差。结果术后所有患者愈合良好,无明显并发症。LeFortⅠ型截骨、颏成形、腓骨重建、髂骨重建位移误差均值最大值分别为0.84、0.64、1.27、1.18 mm。误差均为临床所接受范围。结论基于钉孔共用理念设计的数字化导板在正颌外科及颌骨重建中有较高的精确性,具有临床应用价值。

英文摘要

ObjectiveThis study aimed to investigate the application of digital guide plate based on the drill-hole sharing concept in orthognathic surgery and mandibular reconstruction.

MethodsSixteen patients with maxillofacial deformity requiring orthognathic surgery and 10 patients requiring mandibular reconstruction were selected as the research objects. Patients with maxillofacial deformity were scanned by computed tomography (CT), gypsum mold of the maxilla and mandibular arch were scanned using a laser surface scanner, and the fibula or iliac bone of the patients who needed mandibular reconstruction were scanned by CT to create a 3D model. The osteotomy and repositioning guides based on the drill-hole sharing concept were manufactured by digital technology. The guide plate was used to guide osteotomy and reposition the bone segment. Postoperative CT scan was performed. The displacement error of the bone segment was compared between the preoperative virtual surgery and the actual surgery to evaluate the accuracy of the guide plate, by measuring the distance between the landmarks and three reference planes and the distance between the two landmarks.

ResultsThe wounds healed well in all patients, and no serious complications were observed. The maximum mean values of LeFort Ⅰ osteotomy, genioplasty, fibular reconstruction, and iliac reconstruction were 0.84, 0.64, 1.27, and 1.18 mm, respectively; these values were acceptable by clinical standards.

ConclusionThe digital guide plate based on the drill-hole sharing concept has high accuracy and clinical application value in orthognathic surgery and mandibular reconstruction.

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