摘要
目的 探讨3D打印技术制作的截骨导板在双侧下颌升支矢状劈开截骨术（BSSO）中的应用效果。方法 选择32例（男17例,女15例,年龄19~35岁,平均23.5岁）下颌发育不良的患者为研究对象,进行BSSO（Hunsuck模式,64侧）,所有患者术前均进行锥形束CT（CBCT）扫描并建立下颌骨3D模型,使用3D打印技术制作下颌骨升支内侧水平骨切口截骨导板。64侧手术分别由年轻主治医师或具有丰富正颌手术经验的专家（主任医师）使用或不使用截骨导板来完成,对各组完成下颌升支内侧水平骨切口的时间进行计时。术后复查CBCT并按照LSS（lingual split scale）分类来评估手术效果。结果 术后所有患者口内切口均一期愈合,无严重并发症。各组完成下颌升支内侧水平骨切口时间的差异有统计学意义（F=30.059,P0.05）。尽管所有64侧手术均按照标准方式进行,仅有59.38%（38/64）的骨折线遵循标准Hunsuck骨劈开线,21.88%（14/64）骨折线累及下颌神经管,其余18.75%（12/64）是其他方式。经列联表分析和Fisher确切概率法检验发现,截骨导板的使用影响舌侧骨劈开线的方式（P〈0.05）。结论 3D打印技术制作的截骨导板能够帮助年轻医师更快更好地完成BSSO。
Objective To investigate the application of osteotomy template manufactured via 3D printing technique in bilateral sagittal split osteotomy （BSSO）. Methods The patient group consisted of 32 patients （17 males and 15 females） with mandibular hypoplasia who underwent a BSSO setback （Hunsuck modification; 64 splits）. The mean age at the time of surgery was 23.5 years （range 19-35 years）. All patients were scanned using cone beam computed tomography （CBCT） to create a 3D model of the mandibular, and the osteotomy template of the inner horizontal ramus of mandible bone incision was manufactured via 3D printing technique. All splits underwent operation with or without the osteotomy template by either a young doctor （attending doctor） or a doctor with extensive orthognathic surgery experience （chief doctor）. The time it took to perform the mandible bone incision of the inner horizontal ramus of each group was recorded. Postoperative CBCT scan was performed, and the lingual split scale was used to assess the effect of the operation. Results Primary healing of incisions was observed in all patients, and no serious complications occurred. The time it took to perform the mandible bone incision of the inner horizontal ramus was significantly different in the four groups （F=30.059, P〈0.05）, and it was longer in the group of the attending doctor without osteotomy template than in the other three groups （P〈0.05）. No significant difference was observed in the other groups （P〉0.05）. Although all splits （n=64） were performed according to the standardized protocol, only 59.38% （38/64） of the fracture lines run according to the Hunsuck＇s description. By contrast, only 21.88% （14/64） run through the mandibular canal and 18.75% （12/64） was split. The database was analyzed using crosstabs and via Fisher exact test. The split pattern was influenced by the application of an osteotomy template （P〈0.05）. Conclusion The application of osteotomy template manufactured via 3D printing technique in BSSO was effective, which enabled the young doctor to complete the operation faster and with good results.
出处
《华西口腔医学杂志》
CAS
CSCD
北大核心
2015年第5期504-508,共5页
West China Journal of Stomatology
关键词
3D打印技术
双侧下颌升支矢状劈开截骨术
锥形束CT
快速成型技术
计算机辅助设计与制造
3D printing technique
bilateral sagittal split osteotomy
cone beam computed tomography
rapid prototyping
computer-aided design and computer-aided manufacturing
