3D打印技术在颌骨精确功能性重建的应用

Application of 3D printing technology in the precise functional reconstruction of jaws

随着计算机辅助外科和3D打印快速成型技术的发展,数字化外科在医学领域特别是口腔颌面外科领域得到了迅速发展。3D打印技术已应用于颌骨功能性修复重建中,术前通过软件构建3D数字模型,规划截骨范围、移植骨塑形及种植体植入方案,设计并3D打印个性化手术器具导板,可在术中实现颌骨肿物的精确切除、移植骨就位及种植体的精确植入。术后精度及功能评估显示3D打印技术可达到颌骨重建同期种植体植入预期的精确度和生物力学目标,联合种植牙修复可改善患者术后的咬合及咀嚼功能。尽管如此,3D打印技术目前仍存在术前准备耗时长等缺点,进一步开发3D打印技术、优化手术方案、寻找骨替代的生物材料将是未来的重点发展方向。笔者结合国内外文献及本课题组的研究成果,对3D打印技术功能性重建颌骨的流程以及应用前景进行评述,以期为口腔颌面外科医生提供参考。

With the development of computer-aided surgery and rapid prototyping via 3D printing technology,digital surgery has rapidly advanced in clinical practice,especially in the field of oral and maxillofacial surgery.3D printing technology has been applied to the functional restoration and reconstruction of the jawbone.Before surgery,a 3D digital model is constructed through software to plan the scope of the osteotomy,shape the bone graft and plan the placement of the implant.Additionally,3D models of personalized surgical instrument guides are printed prior to surgery.With these3D-printed models and guides,accurate excision of the jaw tumor,accurate placement of the grafted bone and precise placement of implants can be achieved during surgery.Postoperative evaluation of accuracy and function shows that 3D printing technology can aid in achieving the biomechanical goals of simultaneous implant placement in jaw reconstruction,and in combination with dental implant restoration,the technology can improve patients’ postoperative occlusal and masticatory functions.Nevertheless,3D printing technology still has limitations,such as time-consuming preparation before surgery.In the future,further development of 3D printing technology,optimization of surgical plans,and alternative biological materials are needed.Based on domestic and foreign literature and our research results,we have reviewed the process and clinical application prospects of jaw reconstruction via 3D printing technology to provide a reference for oral and maxillofacial surgeons.