3D打印技术在上颌Le Fort Ⅰ型截骨术中的应用

Application of 3D Printing Technique in LeFort Ⅰ Osteotomy

目的:探讨3D打印技术制作的定位导板在上颌Le FortⅠ型截骨术中的应用效果。方法:选择牙颌面畸形患者8例,男4例,女4例;年龄18~32岁,平均24.6岁。所有患者术前均行头颅CT扫描,将CT数据导入Mimics16.0,重建出上颌骨和下颌骨的三维模型,用3-matic 9.0设计定位导板,在上颌Le Fort I型截骨线的上方骨壁厚的位置选4个点作为标志点,利用这4个标志点来定位上颌骨术后的位置,设计好后采用光敏树脂用三维打印机打印制作,在术中应用。结果:所有患者均采用新的方法行正颌手术,上颌骨模拟位置和术后实际位置绝对差异的平均值小于1mm,患者对术后美学效果均满意。结论:初步的结果显示此技术定位上颌骨精确,可在临床应用。

Objective： To guide the repositioning of maxilla in Le Fort I osteotomy, and illustrate its feasibility and validity. Methods： Eight patients （4 males and 4 females） with dental maxillofacial deformities were included. The mean age at the time of surgery was 24.6 years （range 18～32 years）. Spinal CT scan was used for each patient to create a 3D skull model. The data were imported to Mimics 16.0 to calculate the maxilla and mandible 3D model. The dental cast was scanned with 3shape scanner, which was registered with CT data. The mark plate and position plate were designed with 3-matic software and manufactured via 3D printing technique. All patients were scanned again using spinal CT 7 days postoperatively. The maxilla position of virtual simulation and postoperative actual position were compared with Wilcoxon signed rank test. Results： All patients were operated with the novel method without uncontrolled bleeding, plate break and difficult position. The preliminary results showed that clinically acceptable precision for the position of the maxilla was achieved. All patients were satisfied with the aesthetic results. Conclusions： The preliminary results showed that clinically acceptable precision for the position of the maxilla could be achieved using this 3D printed template.