正颌手术三维牙颌融合模型牙列配准精度检验的方法建立

Establishment of a Method for Dentition Registration Accuracy Test of ThreeDimensional Dental and Maxillary Fusion Model in Orthognathic Surgery

目的:应用医学图像软件的组合功能,建立正颌手术三维牙颌融合模型的牙列配准精度检验的新方法,并评价其临床可行性。方法:收集2016年10月-2018年8月于空军军医大学口腔医院颌面外科就诊的16例术前三维牙颌融合模型存在咬合误差经修正且已完成手术的正颌病例,基于Mimics21.0软件的布尔运算功能,对修正方案前的三维牙颌融合模型的上、下牙列咬合接触进行检验,与修正后方案做对比。采用SPSS25.0对结果进行统计学分析,验证其可行性。结果:建立了正颌手术三维牙颌融合模型的牙列配准精度检验的新方法,通过修正前、后手术方案的对比,重叠部分平均体积224.11mm3,与重叠对照组(平均值0.22mm3)对比有显著性差异,具有统计学意义(P<0.05);开牙合部分平均体积2340.24mm3,与开牙合对照组(平均值1.47mm3)对比有显著性差异,具有统计学意义(P<0.05)。结论:应用医学图像软件的组合功能可对正颌手术三维牙颌融合模型牙列配准精度进行检验,本方法可应用于临床虚拟手术方案的初步校正,并提高精确性。

Objective To establish a new method for dentition registration accuracy test of three-dimensional dental-jaw fusion model of orthognathic surgery by using the combination function of medical image software, and evaluate its clinical feasibility. Methods Sixteen cases whose preoperative three-dimensional dental fusion models were corrected and performed in the department of Maxillofacial Surgery, School of Stomatology from October 2016 to August 2018 were collected. Based on Mimics 21.0 software, the Boolean operation function tested the occlusal contact of the upper and lower dentition of the three-dimensional dental-jaw fusion model before the correction scheme, and compared it with the revised scheme. The results were statistically analyzed using SPSS 25.0 to verify its feasibility. Results A new method for the dentition registration accuracy test of the three-dimensional dental-jaw fusion model surgery was established. There is a significant difference (P <0.05) between the overlapping group (the average volume of the overlapping part was 224.11 mm^3) and the overlapping control group (mean 0.22 mm^3) by comparing the anterior and posterior surgical procedures. The average volume of the open sputum was 2340.24 mm^3 in the open sputum group, which was significantly different from the open sputum control group (mean 1.47 mm3)(P <0.05). Conclusion The combination function of medical image software can be used to test the dentition registration accuracy of the three-dimensional dental-jaw fusion model. This method can be applied to the correction of clinical virtual surgical plan and improve the accuracy.