应用CAD/CAM技术进行个体化下颌骨重建

A clinical study of individualized CAD/CAM technique for mandibular reconstruction

目的:探讨计算机辅助设计和制造技术(CAD/CAM)应用于下颌骨肿瘤切除术后骨缺损的个体化修复重建。方法:选择面部畸形明显的单侧下颌骨成釉细胞瘤4例,术前行下颌骨螺旋CT扫描,三维重建成像,用CAD/CAM数控技术和镜像技术,制成与患者骨组织完全相同的个体化实体模型,根据模型预弯制重建钛板。手术切除病灶下颌骨,切取髂骨节段,植于重建板的舌侧,固定重建板于正常下颌骨端。结果:CT三维重建影像与实体模型测量数据接近;预弯制钛重建板与下颌骨匹配;手术恢复了下颌骨的连续性和功能,面部外形对称,X线片显示重建的下颌骨高度和厚度适中。结论:CAD/CAM技术为术前设计提供了个体化实体模型,提高了手术的精确性,节省了手术时间,降低了手术并发症。

PURPOSE: To study the application of CAD/CAM in individual reconstruction of mandible defects after mandibular tumor resection. METHODS: Four patients with facial defect of unilateral mandibular ameloblastoma were scanned with CT and reconstructed 3-dimentional mandibular images before operation.Simulated models which were similar to their own mandibles were made,then prepared for titanium palate according to the models.In operation,the involved mandible was resected, a segment of the ilium was harvested to implant in the lingual side of the reconstructive titanium palate which had been fixed to the normal position. RESULTS: The measurement of 3D-CT reconstructive image and that of the original model were nearly equal.The Ti-palate reconstruction matched with the mandible.The mandible continuity and functions, and facial contour were satisfactorily rehabilated. Normal height or thickness was shown by X ray. CONCLUSION: The CAD/CAM technique can provide individual models preoperation,improve operation accuracy,save time and lower complications.