计算机辅助设计结合三维打印手术导板在面部不对称畸形矫治中的应用

目的本研究旨在观察双颌手术结合三维打印技术制作的定位手术导板在矫治上颌骨垂直向发育过度和下颌前突型不对称畸形的临床应用效果。方法选取14名因单侧上颌骨垂直向发育过度伴发下颌前突的不对称畸形患者,在快速原型技术制作的定位导板的辅助下,于短面侧行上颌Le FortⅠ型骨切开术和下颌支矢状骨劈开术,于长面侧行上颌Le FortⅠ型骨切开术和下颌支垂直骨切开术。分别在手术前、术后7 d、术后1年测量并对比上颌牙合平面偏斜度、下颌支倾斜度、下颌骨偏离度、颏部偏斜度等参数。结果所有患者的颌面不对称均得以矫治并达到满意效果。两侧术前的参数有明显差异(P<0.05),然而术后并无明显区别(P>0.05)。结论计算机辅助技术结合三维打印技术制作的手术定位导板将有助于进一步提高手术可预测性与准确性。

Application of guiding templates and splints fabricated by rapid prototyping technique in correction of facial asymmetry

Objective To evaluate the efficacy of combined orthognathic surgeries and guiding templates and splints fabricated by rapid prototyping technique in the correction of facial asymmetry associated with vertical maxillary excess and mandibular prognathism. Methods 14 patients underwent a maxillary Le Fort I osteotomy, a sagittal split ramus osteotomy on the shorter side of the face, and an intraoral vertical ramus osteotomy on the longer side of the face with the aid of guiding templates and splints fabricated by rapid pro?totyping technique. Parameters including maxillary canting, ramal inclination, mandibular deviation, and chin inclination were meas?ured before surgery, 7 days after surgery, and 1 year after surgery, and data were compared. Results Facial asymmetry was corrected in all patients with satisfactory outcomes. There were significant differences in these parameters between the two sides preoperatively ( P<0.05) , whereas no differences were observed postoperatively ( P>0.05) . Conclusion Guiding templates and splints can help to im?prove the accuracy and predictability over traditional procedures for the correction of facial asymmetry associated with vertical maxillary excess and mandibular prognathism.