基于三维CT重建的快速成型技术在下颌骨重建的临床应用

目的 评价基于三维CT重建的快速成型技术在下颌骨重建中的作用。 方法 本组选取7例下颌骨病变病例，术前均采用基于三维CT重建的快速成型技术，制作下颌骨实体模型，并在实体模型上设计下颌骨切骨范围和拟用髂骨瓣或腓骨瓣的骨量和形态。术中按拟定方案切除下颌骨病变，并同期以钛板、血管化游离腓骨瓣或髂骨瓣修复下颌骨缺损，术后定期观察随访。 结果 采用游离髂骨瓣移植修复者3例，游离腓骨瓣移植者3例，单纯以重建钛板固定者1例。移植骨块均顺利成活。已随访6个月~2年。下颌骨形态和面型基本对称，无下颌偏颌。余留牙咬合关系同术前，张口度正常，咀嚼和语音功能恢复良好。 结论 基于三维CT重建的快速成型技术为下颌骨缺损的个体化和功能性修复提供良好桥梁。

Application of three-dimensional CT-based rapid prototyping technique in clinical mandibular reconstruction

Objective To evaluate the effects of the three-dimensional (3D) CT-based rapid prototyping technique on clinical mandibular reconstruction.Methods Seven patients suffering from mandibular lesion were selected,and surgery was designed preoperatively on the 3-D model which was created by using the rapid prototyping technique and based on the 3-D CT scanning data.Guided by the preoperative design,the mandibular lesion was excised and the following bone defect was immediately reconstructed with a vascularized iliac osteomyocutaneous flap or a vascularized fibular flap,or just a simple reconstructive titanium plate.The patients were then followed up regularly.Results The mandibular defect was reconstructed with the vascularized iliac flap in three patients,with the vascularized fibular flap in three patients and with a simple titanium plate in one patient.The patients had been followed up for 6-24 months.The contour of the reconstructed mandible was symmetrical in all patients.No malocclusion or limitation of mouth opening was found.The postoperative functions of mastication and speech were satisfactory in all patients.Conclusions Reconstruction of mandibular defect can benefit from the application of the 3D CT-based rapid prototyping technique.