三维打印钛合金修复体修复下颌骨缺损的临床应用

Clinical application of three-dimensional printed titanium alloy prosthesis in the reconstruction of mandibular defects

目的探讨三维打印钛合金修复体在下颌骨缺损重建中的临床应用。方法回顾性分析2019年4月至2021年12月武汉大学口腔医院口腔颌面-头颈肿瘤外科3例需行大面积颌骨缺损修复但没有自体骨移植条件或拒绝自体骨移植的患者资料。术前对患者进行CT颌骨扫描,制定虚拟手术计划,设计、制作钛合金修复体及手术导板。使用三维打印钛合金修复体完成下颌骨缺损的修复。术后随访评估患者功能及外形恢复情况。结果3例患者均为男性,年龄分别为27岁、10岁8个月、74岁,2例因下颌骨肿瘤术后复发,1例因牙龈肿瘤术后下颌骨缺损影响面容及进食入院治疗。3例患者手术均顺利完成,术后分别门诊随访36、32、6个月,复查示面部轮廓基本对称,开口度正常,健侧咬合基本正常。未见修复体暴露、松脱、折断。结论三维打印钛合金修复体能够有效地恢复患者面部轮廓及下颌功能。

Objective To introduce the clinical application of three-dimensional(3D)printed titanium alloy prosthesis in the reconstruction of mandibular defects.Methods Three patients with extensive mandibular defects,who were either ineligible for or refused autologous bone transplantation were selected from the Oral and Maxillofacial-Head and Neck Oncology Department at School&Hospital of Stomatology,Wuhan University between April 2019 and December 2021.Preoperative oral and maxillofacial CT scanning was performed,followed by a virtual surgical plan and the design and manufacture of titanium mandibular prosthesis as well as the surgery guide-plate.Repair of mandibular defects using 3D printed titanium mandibular prosthesis.Follow-up after surgery to evaluate the patient’s functional and cosmetic recovery.Results The study included three male patients aged 27,10 years and 8 months,and 74 years,respectively.Two cases involved recurrent mandibular tumors postoperatively,and one case involved mandibular defects following gingival tumor surgery that affected the patient’s facial appearance and eating.All surgeries were successfully completed,with postoperative outpatient follow-ups at 36,32,and 6 months,respectively.Follow-up indicated that the facial contours were basically symmetrical,the degree of mouth opening was normal,and the occlusion on the healthy side was essentially normal.No exposure,loosening,or fracturing of the prostheses was observed.Conclusion 3D printed titanium mandibular prosthesis can effectively restore the facial contour and mandibular function of patients.