3D打印个性化钛网应用于引导骨再生术的精度研究

Research on Implantation Accuracy of 3D Printing Individualized Titanium Mesh in Guided Bone Regeneration

目的:研究3D打印个性化钛网(3D printing individualized titanium mesh)在牙槽骨引导骨再生手术过程中的植入精度。方法:将9例因严重牙槽骨缺损而使用3D打印个性化钛网作为支架材料进行引导骨再生术(guided bone regeneration,GBR)患者的术后即刻和术后6~9个月的CBCT数据进行三维重建,将实际钛网与术前设计钛网模型进行数字化拟合,比较钛网整体偏差及形变角度。结果:GBR术后即刻钛网与术前设计钛网之间平均偏差为(0.76±0.23)mm;术后6~9个月钛网与术前设计钛网之间平均偏差为(0.71±0.19)mm;术后6~9个月钛网与术后即刻钛网之间平均偏差为(0.35±0.11)mm。最大偏差值出现在术后即刻钛网与术前设计钛网之间,为3.50 mm。钛网形变角度结果显示,与术前设计相比,GBR术后即刻钛网的形变角度最大为21.49°,最小为0°,平均为(9.92±8.72)°。钛网形变角度与平均偏差相关性分析结果显示,钛网形变角度越大,其与设计钛网产生的偏差越大。结论:3D打印个性化钛网应用于牙槽骨引导骨再生术,钛网实际位置及形态较术前设计存在偏差,需要进一步研究提高3D打印个性化钛网在GBR中的植入精度。

Objective:To investigate the accuracy of three dimensional printing individualized titanium mesh(3D-PITM)in alveolar bone guided bone regeneration surgery.Methods:CBCT data of 9 patients who underwent guided bone regeneration using 3D-PITM as scaffold material due to severe alveolar bone defects were reconstructed in three dimensions immediately after surgery and 6-9 months after surgery,and the actual titanium mesh was digitally fitted with the preoperative designed titanium mesh model to compare the overall deviation and deformation of the titanium mesh.Results:The average deviation of titanium mesh between immediate post-GBR surgery and preoperative design was(0.76±0.23)mm;between 6-9 months post-GBR surgery and preoperative design was(0.71±0.19)mm;and between 6-9 months post-GBR surgery and immediate post-GBR surgery was(0.35±0.11)mm.The largest deviation value occurred between immediate post-GBR surgery and the preoperative design(3.50 mm).Compared with preoperative design,the largest deformation angle of titanium mesh of immediate post-GBR surgery was 21.49°,the smallest was 0°,and the average was(9.92±8.72)°.The correlation analysis showed that the larger the deformation angle of titanium mesh after GBR surgery,the larger the deviation between it and the preoperative design.Conclusion:The actual position of titanium mesh was still deviated from the preoperative design during 3D-PITM guided bone regeneration.It is necessary to study and improve the accuracy of 3D-PITM guided bone regeneration.