三维打印手术导板在偏颌畸形正颌外科治疗中的初步应用

Preliminary application of three dimensional printing surgical guide plate in orthognathic surgery for partial mandibular deformities

目的探讨对偏颌畸形患者应用计算机辅助设计与三维打印技术制作个性化手术导板,评价其在正颌外科治疗中的有效性。方法选取5例偏颌畸形患者,术前进行颌骨CT扫描与牙齿激光扫描,数据三维重建与融合后进行虚拟手术设计,根据手术设计方案双颌加颏成形术式,设计并三维打印上颌骨Le Fort I型截骨术钛合金、颏成形术树脂截骨与定位导板,下颌支矢状劈开术采用三维打印颌板技术。术后结果与手术规划进行三维测量,并统计比较分析。结果手术导板应用顺利,上颌骨最大误差为1.2 mm(0.3~1.2 mm),颏成形术最大误差为1.7 mm(0.5~1.7 mm),平均误差小于1 mm。术后随访12个月未见不良事件。结论三维打印手术导板可以准确地提供截骨信息,有效地控制颌骨移动,提高了偏颌畸形患者正颌手术精度。

Objective To evaluate the effectiveness of computer aided design(CAD)and three bit printing in the management of orthognathic surgery.Methods A total of 5 cases of patients with jaw deformity were involved in this study;jaw teeth and CT scanning laser scanning before surgery,virtual surgery design of 3D reconstruction and fusion data were analyzed,according to the design scheme of double jaw surgery combined with genioplasty;design and 3D printing of maxillary Le Fort I osteotomy,genioplasty titanium alloy resin osteotomy and positioning guide,sagittal split ramus osteotomy by 3D printing and plate technology were used in this approach.The postoperative results were compared with the surgical planning by three-dimensional measurement and statistical analysis.Results When the operation guide plate was applied smoothly,the maximum error for maxilla was 1.2 mm(0.3-1.2 mm),and the maximum error for genioplasty was 1.7 mm,(0.5-1.7 mm),and the mean error was less than 1 mm.Follow-up for 12 months showed no adverse reaction.Conclusions Three dimensional printing surgical guide plate can accurately provide the osteotomy information,effectively control the jaw movement,and improve the orthognathic surgery accuracy of patients with partial jaw deformity.