三维打印导板辅助下的微创根尖手术新方法

目的:探讨数字化术前诊断设计、三维打印技术及手术导板在显微根尖手术中应用效果。方法:选取根管治疗失败患者1例。术前拍开口位锥形术CT,硅橡胶印模、模型灌注及模型扫描,CBCT与扫描数据整合;软件分析、模拟设计及输出导板的STL数据;3D导板打印制作;并在3D导板指引下,行微创根尖外科手术。结果:微创根尖手术精准切除了根尖病变区,最大程度地减少对骨组织的损伤,缩短了术中治疗时间,提高了患者的满意度和舒适度。结论:采用数字化技术、三维打印导板能有效实现根尖手术可视化、微创化、精确化、快速化、简单化,并降低技术敏感性。

A New Method for Minimally Invasive Apical Surgery with the Aid of Three-dimensional Printed Template

Objective: To evaluate the application effect of digital preoperative diagnosis, planning, 3D printing technology and related surgical template. Methods: A patient suffered from the failure of root canal therapy was chosen. An open position cone beam computed tomography (CBCT) before the surgery was made. A model was fabricated following the step of silicone rubber impression manufacture and model pouring. Surface scan was performed and matched using software. A virtual template was designed using software, and the data were exported as a .STL file and sent to a 3D printer for template fabrication. The minimally invasive apical surgery was then performed with the pre-made 3D printing template. Results: The periapical pathological tissue was removed accurately with minimum lesion to osseous tissue. The operation time was reduced and the patient’s satisfaction and comfort were improved. Conclusion: The digital technology and the 3D printing template used in this case were visualize and accurate, which accelerated the clinical procedure of treating apical periodontitis and thus lowered the technique sensitivity.