3D打印技术在下颌骨缺损修复中应用的初步临床研

目的:探讨应用3D打印技术制作个性化植入体在修复下颌骨缺损中应用的临床效果。方法:选择下颌骨节段性缺损患者3例,术前均行下颌骨CT扫描后三维重建获得数字化下颌骨模型,其中2例应用3D打印技术制作下颌骨树脂模型,术前根据实体模型完成重建板的个体化塑形;1例将设计完善的下颌骨植入体数据输入钛合金3D打印设备,直接获得带髁状突的个性化植入体。按术前设计对病变下颌骨行节段性切除,植入个性化下颌骨植入体,或同期行髂骨移植。结果:将3D打印技术应用于下颌骨缺损修复,个性化植入体术中就位顺利,操作简便,髂骨塑形快而准确。随访3~11个月,患者对面形满意,咬牙合关系正常稳定,植入体无松动、移位及脱落。结论:将3D打印技术应用于修复下颌骨缺损,不仅缩短了手术时间,减少了手术创伤,同时也提高了下颌骨重建的精确性,达到了美观与功能兼备的效果。为下颌骨仿真修复提供了一条快速有效的途径。

Preliminary Clinical Study on the Application of Three Dimensional Printing Technology to Reconstruct Mandibular Defects.

Objective: To investigate the clinical efficacy of implants individualized by three dimensional printing technology in reconstruction of mandibular defects. Methods: Included in this study were three patients with segmental defects of mandible. The digital data of three dimensional mandibular model were obtained by spiral CT. In two out of three cases, a resin model of mandible was made by 3D printing technology and then the titanium plate for reconstruction was individualized according to the resin model before operation. In the rest one case, the digital data of the implant were carefully designed before operation, and directly inputted into the three dimensional printing machine so that an individualized implant with condyle was manufactured. The lesion segment in mandible was resected according to pre-operation design, and meanwhile the printed implant or ilia graft was planted. Results: In application of three dimensional printing technology in reconstructing mandibular defects, customized implants fitted the defects smoothly; the operations became much easier; bone remodeling became quicker and more accurate. All patients were followed up for 3-11 months, and they were satisfied with the aesthetic outcome. Meanwhile stable occlusions were gained and no loosening, displacing or losing of the plant was found. Conclusion: Application of three dimensional printing technology to repair mandibular defects can not only shorten the operation time, reduce the surgical trauma, but also improve the accuracy of mandibular reconstruction, and achieve both aesthetics and function at the same time, which provides a fast and effective method for the simulated reconstruction of mandible.