数字化技术在微创牙槽外科的临床应用

Clinical Application of Digital Technology in Minimally Invasive Alveolar Surgery

目的探索数字化技术——3D打印导板在微创牙槽外科的临床应用效果。方法 2017年10月至2018年1月期间,选取6例颌骨内完全埋伏牙或囊肿患者,对患者颌骨行CT扫描,利用Mimics17.0软件对Dicom格式的CT数据进行三维重建,软件模拟手术,确定手术方案,制作辅助手术导板。运用3D打印导板辅助超声骨刀去骨,拔出埋伏牙或摘除囊肿。结果 6例患者均顺利完成手术,术中切口均位于完全埋伏牙或囊肿表面,有效减少了额外骨组织的损伤,无邻牙牙根及邻近神经血管的损伤,术后患者感觉良好。结论数字化技术——3D打印导板能将术前设计的手术开窗位置、方向等准确无误地转移到患者口内,提供精确定位,并能辅助超声骨刀微创拔除完全埋伏牙或摘除囊肿,最大限度减少周围骨组织的损伤,符合现在牙槽外科精准、微创的理念,具有广阔的应用前景。

Objective To explore the clinical efficacy of digital technology-3D printing guide in minimally invasive alveolar surgery.Methods From October 2017 to January 2018,6 patients with completely impacted tooth or cyst were selected.After CT scan,the Dicom format CT data was used for three-dimensional reconstruction by mimics17.0 software.Then the surgical plan was determined by utilizing software for surgery simulation,and the surgical guide was made at the same time.3D printing guide technology assisting piezosurgery was used to remove bone,and pull out the impacted tooth and cyst.Results All the 6 patients completed the operation successfully.All incisions were located on the surface of impacted teeth or cysts,which effectively reduced the damage of extra bony tissue.There was no adjacent tooth root and adjacent neurovascular injury.The patients felt good after surgery.Conclusion The digital technology-3D printing guide can preoperatively design the location and orientation of the fenestration accurately,which provide precise positioning in patients'mouth.It also can assist piezosurgery to remove completely impacted teeth or cyst.In this way it can minimize the unnecessary damage to the surrounding bone tissue,in line with the current alveolar surgery concept of accuracy and minimal invasion,which has broad prospects.