中段桥接式钛合金全下颌骨植入体的设计制作研究

Design and Fabrication of Middle Part Bridging Mandible Prostheses of Titanium Alloy

目的:介绍一种中段桥接式全下颌骨植入体的设计与制作。方法:以1例下颌骨切除术后,颌骨缺损修复不良患者为研究对象,进行中段桥接式钛合金全下颌骨植入体的设计和制作研究。基于患者的下颌骨CT扫描数据资料,依次采用三维重建、计算机辅助设计与有限元力学分析、三维(3D)打印与机械加工技术,设计并制作一种中段桥接板式的全下颌骨植入体。结果:利用患者的CT数据,将下颌骨植入体的体部和升支部位设计为近似解剖形态,体部向前的中段部位设计成桥接板式。桥接板设计在植入体舌侧,临床上可在桥接板唇侧进行自体骨移植,可望避免颏唇部软组织张力性溃烂,同时可在移植骨上实现种植体植入,为后期的咀嚼功能恢复提供基础。再利用3D打印技术,成功和制作了一种个体化的中段桥接板式钛合金全下颌骨植入体。结论:基于钛合金3D打印技术,可以制作个体化中段桥接式钛合金全下颌骨植入体,其临床应用及远期疗效有待进一步观察。

Objective:To introduce the design and manufacture of a middle part bridging mandible prostheses based on 3-dimensional(3D)printing of titanium alloy.Methods:At first,DICOM format DATA of a mandible was gained by CT scanning,and then 3D reconstruction,computer aided design,3D finite element analysis,3D printing and machining work were successively used.Results:An individual middle part bridging mandible prostheses was designed and manufactured successfully.The middle part of the prostheses might provide fixation and stability for graft bone,and the complication of prostheses exposure at the chin might be avoided by bone graft at the middle part.Conclusion:A realistic individual middle part bridging mandible prostheses of titanium alloy can be designed and manufactured,which may provide a new way for functional individual reconstruction of mandible loss.