不同方法制作正颌手术数字化[牙合]板的研究及精确性分析

目的探讨不同方法制作正颌手术数字化牙合]板的流程,并评估其精确性及临床应用价值。方法选择2017年6月—2019年2月就诊于昆明医科大学附属口腔医院口腔颌面外科的牙颌面畸形患者10例为研究对象。分别利用单个软件和多个软件进行术前模拟设计,虚拟截骨,设计数字化牙合]板,并评估二者精确性和工作时间。同时传统模型外科制作传统牙合]板,评估单软件数字化牙合]板的临床运用价值。结果单软件数字化牙合]板最大拟合误差平均值上颌为(0.0111±0.0038)mm,下颌为(0.0107±0.0037)mm。单软件数字化牙合]板最大拟合误差优于多软件数字化牙合]板(P<0.001),各自上下颌面间差异无统计学意义(P>0.05)。牙合]板术中未出现无法就位情况。无论是单颌还是双颌手术,单软件手术模拟时间均少于多软件手术模拟时间。结论不同方法制作数字化牙合]板精确性存在差异,单软件数字化牙合]板精确性优于多软件数字化牙合]板,模拟耗时更少,具有实际应用价值。

Research and accuracy of different methods of digital occlusal splint fabrication for orthognathic surgery

Objective To explore different methods of digital occlusal splint fabrication for orthognathic surgery and evaluate their accuracy and clinical application value.Methods Ten patients at the Department of Oral and Maxillofacial Surgery of Affiliated Stomatological Hospital of Kunming Medical University with dental and maxillofacial deformities were selected from June 2017 to February 2019.Pre-operative simulation design,virtual osteotomy,and digital occlusal splint design were conducted using single and multiple software,and the accuracy and working time of the resulting digital occlusal splints were evaluated.A traditional occlusal splint was also manufactured by plaster model surgery to evaluate the accuracy and clinical application value of single-software digital occlusal splints.Results The average maximum fusion error of the single-software digital occlusal splint was(0.0111±0.0038)mm in the maxilla and(0.0107±0.0037)mm in the mandible.The maximum fusion error of the single-software digital occlusal splint was better than that of the multi-software digital occlusal splint(P<0.001),and no significant difference between the maxilla and mandible was observed(P>0.05).There was no case that the occlusal splint can,t be brought in during the operation.The simulation time of single-software operation was less than that of multi-software operation in both single-and double-jaw operations.Conclusion Digital occlusal splints prepared by different methods show different levels of accuracy.Single-software digital occlusal splints offer higher accuracy than multi-software digital occlusal splints Moreover,the simulation time of single-software operation is less than that of multi-software operation.Thus,single-software digital occlusal splints have great practical application value.