数字化技术制作唇腭裂术前矫治器的创新性应用

The innovative application of digitally designed appliance for preoperative cleft lip and palate

目的探讨通过数字化技术预制唇腭裂术前矫治器的新型方法。方法回顾性研究40例单侧完全性唇腭裂患儿，术前通过三维牙槽骨模型采集、计算机辅助设计矫治过程、快速成型粉打印上颌石膏三维实体模型，矫治器制备及佩戴3～4个月，至牙槽裂隙〈2 mm，行唇裂修复术及初期鼻成形术。结果唇腭裂患儿接受矫治治疗后，唇腭裂畸形程度较治疗前有显著改善，其中齿槽裂隙显著减少（P〈0.01），双侧牙槽组织体积较前明显增长（P〈0.01），牙槽骨形态较前更为对称。结论本研究建立唇腭裂术前矫治器数字化设计和制作系统，可以成功地应用于临床术前正畸治疗，使唇腭裂序列治疗变得更加完善。可以在保证术前正畸效果准确性的前提下，大大缩短复诊时间和次数。

ObjectiveThe study presents a new method to prefabricate the nasoalveolar molding appliances for preoperative cleft lip and palate by using three-dimensional technology. MethodsA long term retrospective study of 40 cases of infants with unilateral cleft lip and palate who underwent the preoperative 3D models of alveolar bone acquisition, computer aided design for the rapid prototyping process, gypsum powder printing maxillary three-dimensional entity model and install the appliance for 3-4 months （or alveolar cleft〈2 mm）. Simultaneously, primary rhinoplasty can be done during cleft lip repair. All patients had clinic visits three times each month.ResultsDeformities of infants who underwent this treatment, were significantly improved. The alveolar cleft was significantly reduced （P〈0.01）, while bilateral alveolar tissue volume was significantly increased （P〈0.01）. Alveolar bone morphology was more symmetrical than before.ConclusionsThe digital design and manufacture system of appliances for preoperative cleft lip and palate can be successfully applied to the preoperative orthodontic treatment. The sequence treatment of cleft lip and palate becomes better improved. It can shorten the time duration and the numbers of clinic visit on the basis of ensuring the accuracy of preoperative orthodontic effect.