混合现实技术在下颌骨修复重建手术的效果

Application of mixed reality in mandibular repair and reconstruction

目的探讨混合现实(MR)技术在下颌骨缺损修复重建的应用效果。方法2019年10月至2021年5月,第四军医大学口腔医院腓骨瓣修复重建下颌骨缺损患者18例(男10例、女8例;年龄27~45岁,平均35.4岁),试验分为3组,每组6例。试验1组用MR技术引导下颌骨缺损修复重建,试验2组用3D打印技术辅助修复重建,对照组为传统手术组。用锥形束CT进行手术精确性对比分析,用问卷调查评估医疗沟通、咬合关系、外形恢复、就医体验满意度。结果试验1组和2组下颌骨重建手术的平均偏差分别为(1.75±0.44)mm和(1.81±0.16)mm,均低于对照组的平均偏差(3.05±0.83)mm(t_(MR)=3.38,t_(3D)=3.56,均P<0.01)。试验1组和2组医疗沟通得分[(4.60±0.35)分、(4.52±0.28)分,t_(MR)=2.90,t_(3D)=2.77,均P<0.05]、咬合关系得分[(4.17±0.32)分、(4.28±0.39)分,t_(MR)=3.07,t_(3D)=3.29,均P<0.05]、就医体验得分[(4.26±0.45)分、(4.25±0.67)分,t_(MR)=2.50,t_(3D)=2.26,均P<0.05]均高于对照组得分[(4.02±0.34)分、(3.58±0.33)分、(3.56±0.32)分]。各组间患者外形恢复满意度比较,差异均无统计学意义(均P>0.05)。结论MR技术引导下颌骨修复重建手术精确度较高,有利于咬合关系的恢复、有利于医疗沟通,患者就医体验好。

Objective To explore the effect of mixed reality(MR)application in the reconstruction of mandibular defects.Methods Eighteen patients with mandibular defects were enrolled in this study,including 10 male patients and 8 female patients,whose age ranged from 27 to 45 years,and the mean age was 35.4 years.All the patients were from the Stomatological Hospital of the Fourth Military Medical University,during October 2019 to May 2021.Fibular flaps were used for the reconstruction of the mandibular defects.The patients were randomly divided into three groups,six in each group.In group one,MR-guided mandibular defect repair and reconstruction technique was used.In group two,3D printed guide-assisted mandibular defect repair and reconstruction technique was used,and in the control group,traditional jaw defect repair and reconstruction technique was used.All the procedures were performed by the same team.Cone beam computed tomography(CBCT)was used for analysis of surgical accuracy,and questionnaires were used to evaluate the outcome of medical communication,occlusal relationship,appearance restoration,and medical experience satisfaction.Results The mean surgical errors in the group one and group two were(1.75±0.44)mm and(1.81±0.16)mm respectively,which were both significantly lower than that in the control group(3.05±0.83)mm(t_(MR)=3.38,t_(3D)=3.56,P<0.01).The medical communication(4.60±0.35,4.52±0.28,t_(MR)=2.90,t_(3D)=2.77,P<0.05),occlusal relationship(4.17±0.32,4.28±0.39,t_(MR)=3.07,t_(3D)=3.29,P<0.05),and medical experience satisfaction scores(4.26±0.45,4.25±0.67,t_(MR)=2.50,t_(3D)=2.26,P<0.05)in the experimental groups were significantly higher than those in the control group(4.02±0.34,3.58±0.33,3.56±0.32,respectively).There was no significant difference in the satisfaction of appearance recovery among all the groups(P>0.05).Conclusions MR-guided mandibular repair and reconstruction surgery has high accuracy and is also beneficial to the recovery of occlusal relationship and medical communication.