面部软组织三维重建及测量系统的研制与应用

目的 研究和开发可应用于正畸临床诊断的数字化三维重建和测量系统,进行颌面部软组织结构的三维测量研究。方法 应用4个高精度的数码相机获取颌面部软组织的三维信息,自行研制和开发出应用于面部重建和测量的数字化立体摄影测量硬件系统,在专业计算机立体显示卡上开发面部软组织三维重建和测量软件系统,同时完成面部软组织三维测量分析和旋转观察。结果 应用研制的面部软组织三维重建和测量硬件及软件系统,可以重建出具有真实感的三维图像并在计算机中任意旋转、移动、缩放;面部软组织三维立体测量精度,左侧数码相机对为0．483mm,右侧数码相机为0．419mm。结论 本项研究所建立的面部软组织三维重建和测量系统,具有精度高、速度快、非介入性等特点,为口腔正畸学面部软组织三维结构的诊断、分析提供了一条新途径。     

面部软组织数字化三维重建及测量系统的研制与应用

目的研制和开发一套可应用于正畸临床诊断的数字化三维重建和测量系统,进行颌面部软组织结构的三维测量和研究,并可在计算机中将重建的面部三维图象进行旋转观测、储存和分析。材料方法应用4对高精度的数字相机获取颌面部软组织的三维信息,自行研制和开发出了应用于面部测量和重建的数字化立体摄影测量硬件系统,在专业计算机三维显示卡上开发出面部软组织三维重建和测量软件系统,可同时进行面部软组织三维测量分析与旋转观测。结果应用研制的面部软组织三维重建和测量的硬件和软件系统,可以重建出具有真实感的面部三维图象,并可在计算机中进行任意旋转、移动、缩放重建;建立的面部软组织三维测量系统的测量精度可达到0.5mm,足以满足口腔正畸临床诊断和治疗的需要。结论本研究所建立的面部软组织三维重建和测量系统,具有高精度、高速、非介入性等特点,为口腔正畸学临床诊断和治疗提供了一个崭新的途径。     

面部软组织数字化立体摄影测量原理

目的：阐述应用立体摄影测量系统进行面部软组织三维测量的原理。方法：应用数码相机和数字化立体摄影测量的方法进行面部软组织三维测量。结果：面部软组织立体摄影测量系统可以达到足够高的面部三维测量精度。结论：应用近景摄影测量原理进行面部软组织三维测量的方法可以为口腔正畸学面部软组织三维立体特征的诊断和研究提供一个有效的方法。     

正常面部软组织三维测量

目的 :应用数字化立体摄影测量系统进行正常面部软组织的三维测量。方法 :应用数码相机和我们研制的一套数字化立体摄影测量硬件和软件系统 ,按照一定纳入标准选择 30例正常进行面部软组织三维测量 ,并分男性组与女性组进行对照。结果 :分别建立了正常男性组与女性组的正常值 ,并得到男性组与女性组对照统计分析结果。结论 :本研究应用了一种新的面部软组织三维测量系统对正常面部软组织进行三维测量 ,建立的正常值为错畸形的面部软组织诊断分析提供了新的依据     

正常面部软组织三维测量

目的：应用数字化立体摄影测量系统进行正常He面部软组织的三维测量。方法：应用数码相机和我们研制的一套数字化立体摄影测量硬件和软件系统,按照一定纳入标准选择30例正常He进行面部软组织三维测量。并分男性组与女性组进行对照。结果：分别建立了正常He男性组与女性组的正常值。并得到男性组与女性组对照统计分析结果。结论：本研究应用了一种新的面部软组织三维测量系统对正常He面部软组织进行三维测量。建立的正常值亩划He畸形的面部软组织诊断分析提供了新的依据。     

面部软组织不对称性的三维测量研究

目的 :应用数字化立体摄影测量系统进行正常面部软组织不对称性的三维测量 ,获得面部软组织在三维方向上的不对称向量。方法 :选择 4 0例正常成人进行面部软组织不对称性的三维测量 ,计算面部软组织在三维方向上的不对称向量。结果 :面部软组织不对称性的三维测量结果显示样本的面部软组织在个体和总体上都存在不对称性 ,面部中下部的不对称性更为明显。结论 :三维摄影测量是研究面部不对称性的一种非常有效的分析方法。     

立体摄影颌面部软组织三维重建与测量的研究进展

颌面部软组织三维重建及其在此基础上的测量，在口腔颌面外科学、口腔正畸学、整形外科学、法医学、人类学及美学等领域有着很重要的意义。在面部软组织重建与测量方面，出现了激光扫描、立体摄影、莫尔云纹、结构光技术、CT、MRI等方法，但各有利弊。面部软组织三维立体摄影测量（stereopho-togrammetry）在20世纪90年代初即开始出现。     

北京地区正常(牙合)面部软组织不对称性的三维测量研究

目的应用数字化立体摄影测量系统进行正常(牙合)面部软组织不对称性的三维测量,获得面部软组织在三维方向上的不对称向量.方法选择40例正常(牙合)成人进行面部软组织不对称性的三维测量,计算面部软组织在三维方向上的不对称向量.结果男性组和女性组都是右侧面部较大,但男女无显著性差异;面部不对称量都是在x轴上分布最多;面部越靠面下部的点和越靠外侧面的点,其不对称量越大.结论用三维摄影测量的分析方法显示面部中下部的不对称性更为明显;三维立体摄影测量是较好的研究面部软组织不对称性的方法.     

激光扫描在面部畸形三维重建及测量中的初步应用

目的开发建立一套面部三维结构重建、测量及诊断分析系统。方法应用系统建立标准石膏立方体试件以及石膏头像三维计算机模型并进行定点、测量,测量值与标准值比较获得系统建模误差以及定点误差范围;2例面部畸形患者进行了面部三维扫描建模,应用系统对患者面部计算机模型进行了定点、线距、角度测量以及初步对称性分析。结果三维计算机模型的建模误差在0.2 mm以内,定点误差在0.5 mm以内。应用本系统可以完成三维计算机模型的定点、线距、角度测量及对称性分析工作,基本能够达到临床要求。结论三维激光扫描技术为颌面部畸形患者面部软组织三维结构重建和非接触式测量提供了一种简便、精确、高效的方法。     

正常人群面部软组织三维测量与X线头影测量的相关性分析

目的　比较正常的面部软组织三维测量与X线头影测量结果。方法　应用面部软组织数字化立体摄影测量与X线头影测量对标准正常进行面部软组织三维测量,并进行相关性分析。结果　面部软组织三维测量项目与对应的X线头影测量项目具备相关性。结论　面部软组织三维测量结果能够部分的反映其下硬组织的情况。     

三维光学扫描及快速成形技术制作面部软组织三维树脂模型的初步研究

目的应用三维光学扫描及快速成形技术制作人面部软组织三维树脂模型，为研制颌面赝复体计算机辅助设计（computer aided design，CAD）与计算机辅助制作（computer aided manufacture，CAM）系统奠定基础。方法采用自主研发的三维光学测量系统对志愿者左右侧面部分别进行扫描，通过Surfcaq软件对图像数据进行转换，获得完整的点云数据。以鼻尖点、颏下点、眼眶外侧点作为标定点，在Geomagic studio软件中对点云数据进行拼接、拟合，三维重建面部软组织。将三维重建图像导入MagiCS RP软件，进行三角化，并生成2mm的厚度，利用快速成形设备制作面部软组织三维树脂模型。结果获得了志愿者面部软组织的三维重建图像，并经快速成形制作出面部软组织三维树脂模型。结论利用三维光学扫描可进行人面部软组织三维重建，利用快速成形技术制作面部软组织三维树脂模型切实可行。     

Validation of new soft tissue software in orthognathic surgery planning

This study tests computer imaging software (SurgiCase-CMF^®, Materialise) that enables surgeons to perform virtual orthognathic surgical planning using a three dimensional (3D) utility that previews the final shape of hard and soft tissues. It includes a soft tissue simulation module that has created images of soft tissues altered through bimaxillary orthognathic surgery to correct facial deformities. Cephalometric radiographs and CT scans were taken of each patient before and after surgery. The surgical planning system consists of four stages: CT data reconstruction; 3D model generation of facial hard and soft tissue; different virtual surgical planning and simulation modes; and various preoperative previews of the soft tissues. Surgical planning and simulation is based on a 3D CT reconstructed bone model and soft tissue image generation is based on physical algorithms. The software rapidly follows clinical options to generate a series of simulations and soft tissue models; to avoid TMJ functional problems, pre-surgical plans were evaluated by an orthodontist. Comparing simulation results with postoperative CT data, the reliability of the soft tissues preview was >91%. SurgiCase^® software can provide a realistic, accurate forecast of the patient's facial appearance after surgery.     

三维CT影像在颌骨骨折诊断与治疗中的临床价值

目的 :探讨三维CT影像在颌面部骨折中的诊断价值。方法 :对 17例颌骨骨折的三维CT影像及二维CT影像进行观察 ,分析其各自的特征并进行比较。结果 :三维CT影像在显示骨折的空间位置方面 ,如骨折线的行走路线 ,骨折片的移位距离与方向等都有独到的优势 ,但在显示上窦前壁线型骨折 ,骨折断端周围的软组织改变等方面不如二维CT影像。结论 :三维CT影像在显示颌面骨折处的空间关系上有很大的诊断意义及治疗指导意义 ,可以弥补二维CT影像的不足 ,但不能取代二维CT影像。     

基于二维DR的颅面硬组织与软组织拟合的研究

目的:以数字化X线摄影片(digital radiograph,DR)图像和激光扫描为数据源,三维重建颅面硬组织和软组织,并进行硬软组织的有效拟合,以期为治疗方案确定、手术方法选择和提高医患交流的水平提供平台.方法:在志愿者面部贴定铅点,拍摄头颅正侧位DR片.利用基于二维DR数据的颅面硬组织三维重建系统进行硬组织形变建模.获得颅面部硬组织模型.利用激光扫描数据进行面部软组织三维重建,获得面部软组织三维模型.然后通过铅点坐标的匹配,将颅面硬组织与面部软组织进行拟合.结果:分别重建了能反映真实颅面部组织结构的硬组织三维模型和面部软组织三维模型,并实现了颅面部硬组织与软组织的有效拟合.结论:本研究实现了颅颌面三维结构的有效重建和拟合,为进一步进行正颌手术模拟和容貌预测奠定了基础.拟合结果真实可靠,能够用于临床.     

Three-dimensional virtual reality surgical planning and simulation workbench for orthognathic surgery

A new integrated computer system, the 3-dimensional (3D) virtual reality surgical planning and simulation workbench for orthognathic surgery (VRSP), is presented. Five major functions are implemented in this system: post-processing and reconstruction of computed tomographic (CT) data, transformation of 3D unique coordinate system geometry, generation of 3D color facial soft tissue models, virtual surgical planning and simulation, and presurgical prediction of soft tissue changes. The basic mensuration functions, such as linear and spatial measurements, are also included. The surgical planning and simulation are based on 3D CT reconstructions, whereas soft tissue prediction is based on an individualized, texture-mapped, color facial soft tissue model. The surgeon "enters" the virtual operatory with virtual reality equipment, "holds" a virtual scalpel, and "operates" on a virtual patient to accomplish actual surgical planning, simulation of the surgical procedure, and prediction of soft tissue changes before surgery. As a final result, a quantitative osteotomy-simulated bone model and predicted color facial model with photorealistic quality can be visualized from any arbitrary viewing point in a personal computer system. This system can be installed in any hospital for daily use.     

Vertical distraction of fibula transplant in a case of mandibular defect caused by shotgun injury

This case demonstrates the successful aesthetic and functional reconstruction of a complex facial gun-shot injury with extended bone defects and soft tissue destructions using a 3-step procedure. Initially, a reconstruction plate was inserted, later a fibula transplant enabled the basic reconstruction and finally was distructed in a 3rd session. The rationale behind the sequencing of surgical sessions was the extended bony defect and soft-tissue destruction. The main problem in this type of wound is hypoxia or anoxia of the receptor bed for the transplant. A microvascular anastomosized bone transplant is necessary for sufficient oxygen tension in the recipient site. The anatomical dimensional disproportion of the transplanted free fibula graft and the shape of the mandible were corrected prior to the insertion of dental implants by means of vertical distraction.     

Experience with cranial implant-based prosthetic reconstruction

Reconstruction of acquired or congenitally absent facial structures is a challenging task for the reconstructive surgeon. Often inadequate soft tissue, cartilaginous, or osseous support exists for a reconstruction which is functional, aesthetic, and achieved with a reasonable effort on the part of the surgeon and patient. Prosthetic reconstruction of these structures utilizing cranial implants is a viable option which offers several advantages when compared to traditional reconstructive techniques. We present our experience with 114 cranial implants in 32 patients for craniofacial reconstruction. One hundred fourteen cranial implants were placed in a total of 32 patients for reconstruction of facial structures. Indications for cranial implants with prosthetic reconstruction were lack of adequate tissue for reconstruction, failed reconstructive attempts, and selection of the technique by the patient. Seventy-two implants were placed in the mastoid region, 31 within the orbit, 7 within the nasal cavity, with four additional implants for the reconstruction of eyebrows. Cranial implants were followed by clinical and radiographic examination at intervals ranging from 3-46 months (mean 15.3 months). Patient records were retrospectively reviewed for surgical complications, soft tissue reactions, infections, and implant failures. The total success rate of cranial implantation in the study group was 92.9% (106/114). Surgical complications occurred in three of the 32 patients (9.3%). All cranial implants were successfully reconstructed after integration. Seven percent of the implants failed after initial integration was successful. The rate of significant soft tissue reactions or frank infection observed among the implanted patients was 6.1%. Titanium cranial implants coupled with custom prosthetic reconstruction offer an excellent alternative to traditional surgical techniques in the reconstruction of acquired or congenitally absent facial structures. Predictability, prosthetic adaptability, as well as superior aesthetics are major advantages to this technique when compared to traditional surgical reconstructive techniques.