计算机辅助设计个性化钛修复体在半侧下颌骨缺损修复重建中的应用

Application of computer aided design of personalized titanium prosthesis in hemi-mandibular defect

目的探讨基于数字化设计的个性化钛修复体在半侧下颌骨缺损修复重建中的应用。方法回顾性分析四川大学华西口腔医院创伤与整形外科2007年1月~2012年12月采用个性化钛修复体修复重建半侧下颌骨缺损的11例患者,通过CT扫描获得数据,设计和模拟手术过程,制作个性化钛修复体。手术中切除半侧下颌骨的同期植入个性化钛修复体。经5~7年回访,观察修复体情况、咬合关系和面部外形恢复情况。结果所有患者开口度正常、开口型偏健侧,余留牙咬合关系正常,个性化钛修复体无松动、感染,余留下颌骨未见进行性吸收,X线片未见钛钉松动、骨吸收,个性化钛修复体无松动、变形、断裂。结论对不接受骨移植的半侧下颌骨缺损患者,通过计算机辅助设计个性化钛修复体修复重建是一种较好的治疗选择。

Objective To investigate the application of digital designed personalized titanium prostheses in hemi-mandibular defects.Methods 11 cases of reconstruction of half mandibular defects with individualized titanium prosthesis from January 2007 to December 2012 in trauma and plastic surgery of West China Dental Hospital of Sichuan University were analyzed retrospectively.The data were obtained by CT scanning,and the individualized titanium prosthesis was designed and manufactured by simulating the operation process.During the operation,the half mandible was removed and the individualized titanium prosthesis was implanted at the same time.After 5-7 years of follow-up,the restoration,occlusal relationship and facial contour recovery were observed.Results All patients had normal opening degree,open type partial healthy side,normal occlusion of the remaining teeth,no loosening and infection of personalized titanium prosthesis,no progressive absorption of the remaining jaw,no loosening of titanium nails and bone absorption on X-ray film,and no loosening,deformation and fracture of personalized titanium prosthesis.Conclusion It is a better choice for the patients who do not receive bone transplantation to repair and reconstruct the defects of the mandible.