反求与快速成型技术在复杂颌面骨性病变修复中的应用

Application of reverse engineering and rapid prototyping in the treatment of complicated lesions in cranial-maxillofacial skeleton

目的探索将反求与快速成型技水用于复杂颅颌面骨性病变诊疗过程的可行性和应用价值。方法复杂颅颌面骨性病变患者43例,根据患者头面部CT图像,通过反求和快速成型设计、制作颅面骨骼实体模型、骨性缺损与畸形的个体化修复假体,并在实体模型上进行术前手术模拟和固定器材的预弯。结果反求重建颅面骨骼三维模型,应用快速成型技术把二维图像制造成实体模型。在骨缺损和畸形病例的整复手术中个体化修复假体精密就位,各部件达到设计位置,手术过程顺利,术后外形与健侧对称,达到了术前设计的预期效果,开闭口功能正常无偏斜。术后种植义齿镶复,咀嚼功能恢复良好。结论通过反求设计和快速成型能获得直观、可触的颅颌面骨骼实体模型,可在其上进行手术模拟,以及为颅颌面骨性缺损与畸形设计制作个体化的修复假体,能明显缩短手术时间并提高手术质量,该技术将在复杂颅颌面骨性病变的整个诊治过程中发挥重要作用,具有广泛的应用前景。

Objective To evaluate the feasibility of using reverse engineering and rapid prototyping techniques in the treatment of complicated lesions in cranial-maxillofacial skeleton.Methods In the present study,43 patients who suffered from complicated lesions in cranial-maxillofacial skeleton were enrolled.based on their CT data of 3D solid skull models,the individualized prosthetics for bony defects and deformities were designed and fabricated through multi-step procedure of reverse engineering and rapid prototyping.On the solid skull model,pre-operation simulation were performed and plates for internal fixation were pre-curved,then the operation of individualized prosthetics which filled with cancellous bone and fixed were done.Results Solid model of skull could be achieved in which simulated operation could be performed.The individualized prosthetics fabricated with this method have been successfully used in clinical for cranial-maxillofacial surgery on 43 patients and the post operation lace contour regain symmetry and got a satisfactory result.Conclusion Reverse engineering combining with rapid prototyping could accomplish the design and manufacture of implant for the restoration of cranial-maxillofacial bone defects and deformities.This technique could improve therapeutic quality and shorten operation time,and might play an important role in the treatment of complicated lesions in cranial-maxillofacial skeleton.