3D打印导板辅助髁突骨软骨瘤及继发复杂牙颌面畸形的手术治疗

目的:研究3D打印手术导板辅助髁突骨软骨瘤及继发牙颌面畸形同期矫治的临床可行性。方法:根据影像学资料,运用Dolphin Imaging 11.7 Premium 和Mimics软件进行虚拟外科手术设计并制作3D打印手术导板,指导髁突骨软骨瘤及继发牙颌面畸形的手术矫治。通过对比模拟头颅模型与实际术后CT重建模型评估此方法的临床价值。结果:所有患者患侧关节功能、咬合关系以及颜面对称性都得到了良好的恢复。模拟术后模型与术后扫描重建模型对比中,中切牙与第一磨牙的误差均保持在1.4 mm以下,最大误差出现在颏部,约2.4 mm,显示了新方法的准确性。结论:结果显示虚拟外科手术设计和手术导板有助于髁突骨软骨瘤继发牙颌面畸形的准确诊断、治疗方案设计、准确截骨以及重置骨块。

Treatment of Complex Dentofacial Deformities Secondary to Osteochondroma of the Mandibular Condyle with 3D Printed Surgical Templates.

Objective: To investigate the clinical feasibility of simultaneously treating osteochondroma of the mandibular condyle and its resultant dento-maxillofacial deformities with 3D printed surgical templates. Methods: Virtual surgical simulation was performed according to the imaging data by using two softwares, Dolphin Imaging 11.7 Premium and Mimics software. Surgical templates were fabricated by 3D printing to guide the surgery. The linear differences between virtually simulated and postoperative skull models were evaluated. Results: Successful rehabilitation of condyle function, normal occlusion, and symmetry of the facial profile were achieved in all patients. The linear differences of the incisors and first molars were no more than 1.4 mm, and the greatest difference was found at the mentum, which was up to 2.4 mm, demonstrating the accuracy of the new method. Conclusion: The results suggested that virtual surgical planning and guiding templates facilitated accurate diagnosis, treatment planning, accurate osteotomy and repositioning of bony segments in the treatment of condylar osteochondroma and its resultant facial asymmetry.