3D打印截骨导板辅助赝复体术中修复BrownⅡ类缺损的精准度评价

目的 设计制作3D打印截骨导板用于赝复体术中修复BrownⅡ类缺损,评价其临床应用的精准度.方法 8例因肿瘤致BrownⅡ类缺损患者纳入研究,术前设计制作3D打印截骨导板及赝复体,术中在截骨导板引导下完成手术,即刻戴入赝复体修复缺损,将术前虚拟计划与术后CBCT融合,对整体及局部区域行偏差分析评价手术精准度.应用SPS...     

颅颌面修复体制作用3D打印金属粉末的研究进展

随着3D打印的快速发展,其在口腔颅颌面外科的应用越来越广泛,3D打印个性化生产改变了传统依靠手工成型的落后模式,满足了不同患者的使用需求。但目前对于颅颌面修复体制作用3D打印金属粉末的性能要求并无明确规范,不利于产业的长久发展。本文对颅颌面修复体制作用3D打印金属粉末的制备工艺（气雾化法、等离子体旋转电极雾化法、射频等离子体球化法）以及3D打印成型工艺（选区激光熔化、电子束选区熔化、激光近净成形）进行了介绍,并且根据制备工艺及成型工艺特点总结了颅颌面修复体制作用3D打印金属粉末的性能要求。     

颅颌面修复体制作用3D打印金属粉末的研究进展

随着3D打印的快速发展,其在口腔颅颌面外科的应用越来越广泛,3D打印个性化生产改变了传统依靠手工成型的落后模式,满足了不同患者的使用需求。但目前对于颅颌面修复体制作用3D打印金属粉末的性能要求并无明确规范,不利于产业的长久发展。本文对颅颌面修复体制作用3D打印金属粉末的制备工艺（气雾化法、等离子体旋转电极雾化法、射频等离子体球化法）以及3D打印成型工艺（选区激光熔化、电子束选区熔化、激光近净成形）进行了介绍,并且根据制备工艺及成型工艺特点总结了颅颌面修复体制作用3D打印金属粉末的性能要求。     

Assessment of effect of accelerated aging on interim fixed dental materials using digital technologies

PURPOSEThis study assessed the physical and mechanical properties of interim crown materials fabricated using various digital techniques after accelerated aging.MATERIALS AND METHODSThree groups of interim dental restorative materials (N = 20) were tested. The first group (CO) was fabricated using a conventional manual method. The second group (ML) was prepared from prefabricated resin blocks for the milling method and cut into specimen sizes using a cutting disc. The third group (3D) was additively manufactured using a digital light-processing (DLP) 3D printer. Aging acceleration treatments using toothbrushing and thermocycling simulators were applied to half of the specimens corresponding to three years of usage in the oral environment (N = 10). Surface roughness (Ra), Vickers microhardness, 3-point bending, sorption, and solubility tests were performed. A 2-way analysis of variance (ANOVA) and Fisher’s multiple comparison test were used to compare the results among the groups.RESULTSThe mean surface roughness (Ra) of the resin after accelerated aging was significantly higher in the CO and ML groups than that before aging, but not in the 3D group. All groups showed reduced hardness after accelerated aging. The flexural strength values were highest in the 3D group, followed by the ML and CO groups after accelerated aging. Accelerated aging significantly reduced water sorption in the ML group.CONCLUSIONAccording to the tested material and 3D printer type, both 3D-printed and milled interim restoration resins showed higher flexural strength and modulus, and lower surface roughness than those prepared by the conventional method after accelerated aging.     

Computer-aided design of facial prostheses by means of 3D-data acquisition and following symmetry analysis

The aim of this study was to investigate whether a method of designing digital models of facial prostheses was suitable for patients with orbital defects. 32 patients were included in a retrospective study. 23 of them already had a facial prosthesis. 3D-data of the faces were acquired optically using fringe projection technique without and with (if available) the facial prosthesis in place. The healthy side of the surface models was mirrored to reconstruct the defect area. By generating a NURBS-model, the edges of the virtual prostheses were adapted to the defect region. The CAD models were stored in STL format as templates for facial prostheses. Using an automatically calculated asymmetry index (AI), four situations of the digitized facial surface were analysed for symmetry: 1. with defect area excluded, 2. with mirrored healthy surface, 3. with digital CAD template, and 4. with manually produced facial prosthesis inserted (if available). Mean AI values were 6.05 ± 3.26 (situation 1), 4.79 ± 2.51 (situation 2), 5.12 ± 2.61 (situation), and 6.74 ± 2.77 (situation 4). Additionally, the CAD templates were rated by three anaplastologists. Ratings did not differ significantly. They partially agreed with the three statements “The CAD prosthesis fits harmoniously within the face”, “The CAD prosthesis could be used for a wax pattern during conventional fabrication” and “The CAD prosthesis and the wax pattern reduce workload”. The results indicate that the presented technique has the potential to increase facial symmetry and facilitate the technical procedure. However, symmetry alone is not a sufficient criterion for design of a facial prosthesis.     

3种不同工艺制备聚醚醚酮假体的生物力学性能研究

目的: 检测3种不同工艺制备聚醚醚酮标准件的生物力学性能,评估3D打印技术制备聚醚醚酮人工假体的优势及临床应用前景。方法: 采用等材(注塑成型)、减材(机械加工)、增材(3D打印)3种工艺分别制作生物力学检测所需标准件,并对其进行单轴拉伸、单轴压缩、三点弯曲实验检测其生物力学性能,应用单因素方差分析LSD检验进行组间均数对比分析。结果: 3D打印试件的抗拉能力与机械加工、注塑成型相比无显著性差异;抗弯能力略低于机械加工,与注塑成型相比无显著性差异;抗压能力与机械加工相比无显著性差异,明显优于注塑成型。结论: 3D打印技术制备的聚醚醚酮假体其力学性能较佳,且能更好的满足个性化的临床需求。     

Reconstruction of an Extensive Midfacial Defect Using Additive Manufacturing Techniques

Malignant peripheral nerve sheath tumors are extremely rare tumors arising in peripheral nerves. Only 17 cases involving the trigeminal nerve have ever been reported. These tumors have a very poor prognosis and very high rates of recurrence and metastases. Their recommended treatment involves complete tumor resection followed by radiation. This can be problematic in the head and neck region. We present a clinical case involving a 33‐year‐old female patient presenting with a slow‐growing, exophytic mass of the anterior maxilla. Incisional biopsy and subsequent histological examination revealed a diagnosis of a malignant peripheral nerve sheath tumor. Surgical resection involved a complete maxillectomy, rhinectomy, and resection of the upper lip and aspects of the left and right cheeks. Reconstruction of the subsequent defect incorporated the placement of four zygomatic oncology implants to aid in retention of a facial prosthesis. These implants, however, were subsequently lost; and an anatomical model of the hard tissues was manufactured via 3D printing. This model was used to design and manufacture a titanium frame (customized implant) for the patient. The frame was then fixated and secured intraoperatively with 21 cortical screws. A maxillary denture and silicone facial prosthesis were also made to fit onto this frame. This is the first known case where additive manufacturing, via the use of rapid prototyping and 3D printing, was employed to manufacture a facial prosthesis.     

三维打印血管的研究进展

血管化作为骨、牙髓、皮肤等口腔颌面组织再生的关键,一直是组织工程研究的重点。随着三维(three-dimensional, 3D)打印在组织工程领域的发展,构建血管结构的方式逐渐增加。但要达到在形态及功能上高度模拟血管结构的目的,构建精度较高且具备生物功能的高仿真血管结构以促进组织修复仍是3D生物打印需要克服的一大难点。该文总结了三维打印血管结构的新进展,阐述了几种前沿生物制造技术即悬浮打印、同轴打印、4D打印等在构建血管及血管化结构中的应用,并分析和探讨其优缺点与应用前景,为三维打印血管在口腔颌面组织再生修复方面的应用提供参考。     

Implant-Retained Nasal Prosthesis for a Patient Following Partial Rhinectomy: A Clinical Report

Prosthetic rehabilitation of facial defects has always perplexed maxillofacial prosthodontists. Facial defects lead to functional and cosmetic deficiencies. Early rehabilitation improves patients' quality of life. Osseointegrated rehabilitation of the maxillofacial prosthetic patient presents the potential for overcoming many of the disadvantages associated with conventional retentive methods. This paper presents the clinical report of a patient who had undergone partial rhinectomy due to basal cell carcinoma. Following post-surgical healing, the patient was rehabilitated with a temporary acrylic resin nasal prosthesis retained by eyeglass frame. Later a silicone nasal prosthesis supported by an implant-retained framework was fabricated as a definitive replacement.     

Two‐Piece Nasal Septum Prosthesis for a Large Nasal Septum Perforation: A Clinical Report

Nasal septum perforation presents with the symptoms of epistaxis and crusting. Obturation of the defect will decrease the symptoms and increase patient comfort. Prosthetic closure is more predictable and thus the treatment of choice in larger defects. This article describes a procedure for construction of a magnet‐retained, heat‐processed acrylic nasal septum prosthesis. The two‐piece nasal septum prosthesis was processed and joined together in situ by magnets. Each piece of the septum prosthesis conforms to the remaining medial wall of each nostril and forms the missing half of the nasal septum. The prosthesis not only alleviates symptoms, but also provides structural support to the saddle‐shaped nose and improves esthetics.     

Accuracy of a chairside fused deposition modeling 3D-printed single-tooth surgical template for implant placement: An in vitro comparison with a light cured template

PurposeTo compare the accuracy of a chairside fused deposition modeling (FDM) 3D-printed surgical template with that of a light-cured template for implant placement.Materials and methodsTwenty standard mandibular resin models with missing teeth 36 and 46 were selected. Surgical templates were fabricated using a chairside FDM 3D-printer (test group) or a light-curing 3D printer (control group) (n = 20/group). Forty implants were placed by a clinician blinded to group allocation. The angular, 3D, mesiodistal, buccolingual, and apicocoronal deviations at the implant base and tip between preoperative design and postoperative implant position were recorded.ResultsThe mean angular (test vs control groups: 3.22° ± 1.55° vs 2.74° ± 1.24°, p = 0.343) and 3D deviations at the implant base (test vs control groups: 0.41 ± 0.13 mm vs 0.35 ± 0.11 mm, p = 0.127) and tip (test vs control groups: 0.91 ± 0.34 mm vs 0.75 ± 0.28 mm, p = 0.150) were similar. The mesiodistal, buccolingual, and apicocoronal deviations at the implant base and tip also did not differ significantly between groups (p > 0.05).ConclusionsFor single tooth gap indications, implant placement with an FDM 3D-printed surgical template was as accurate as that with a light-cured template, and more efficient.     

3D打印技术在上颌Le Fort Ⅰ型截骨术中的应用

目的:探讨3D打印技术制作的定位导板在上颌Le Fort Ⅰ型截骨术中的应用效果。方法:选择牙颌面畸形患者8例,男4例,女4例;年龄18~32岁,平均24.6岁。所有患者术前均行头颅CT扫描,将CT数据导入Mimics16.0,重建出上颌骨和下颌骨的三维模型,用3-matic 9.0设计定位导板,在上颌Le Fort I型截骨线的上方骨壁厚的位置选4个点作为标志点,利用这4个标志点来定位上颌骨术后的位置,设计好后采用光敏树脂用三维打印机打印制作,在术中应用。结果:所有患者均采用新的方法行正颌手术,上颌骨模拟位置和术后实际位置绝对差异的平均值小于1 mm,患者对术后美学效果均满意。结论:初步的结果显示此技术定位上颌骨精确,可在临床应用。     

3D打印技术在口腔材料领域的研究进展

 3D打印技术具有精确、快速、易于成型的特点，目前已广泛应用于社会生活的各个领域，也为口腔材料学的发展带来了新的机遇和挑战。文章主要就3D打印技术在口腔材料领域的应用现状做一综述，包括常用的方法、基本步骤、可打印材料以及当下面临的问题等4个方面。