Joffe J M, Nicoll S R, Richards R, Linney A D, Harris M
Department of Medical Physics and Bioengineering, Eastman Dental Institute, University College London, England.
Int J Oral Maxillofac Surg. 1999 Aug;28(4):309-13.
We have constructed 300 titanium cranioplasty plates, over 150 cases using a computerised technique, the remainder by external impression. The clinical follow-up of these cases over 8 years has shown consistently good results that justify our simple low-cost method of manufacturing these plates. Both techniques require the provision of a model on which to construct the plate. In the traditional technique, an approximate model is derived from the resected bone or a direct impression of the defect over the patient's scalp. Using the computerised technique, a more accurate model of the defect and the surrounding bone is milled in polyurethane foam from cross-sectional computerised tomographic (CT) scans. Sheet titanium is pressed to shape from a design outlined on a counterdie. The subsequent stages of the plate construction are then the same for both methods. This study describes the stages of the model manufacture, the validation of its accuracy and the plate construction that follows. Use of the computerised method has resulted in a reduction of errors, enabling the manufacture of a smaller plate than was possible previously. It has also enabled design changes through the achievement of greater accuracy in fit.
我们制作了300块钛颅骨修补板，其中150多例采用计算机技术制作，其余的通过外部印模制作。对这些病例长达8年的临床随访显示，效果一直良好，这证明了我们这种简单低成本制作这些修补板的方法是合理的。两种技术都需要提供一个用于制作修补板的模型。在传统技术中，一个近似模型是从切除的骨头或患者头皮上缺损的直接印模获得的。使用计算机技术时，根据横断面计算机断层扫描（CT）图像在聚氨酯泡沫中铣出一个更精确的缺损及周围骨骼的模型。根据凹模上勾勒的设计将钛板压制成型。两种方法后续的修补板制作步骤相同。本研究描述了模型制作的步骤、其准确性的验证以及后续的修补板制作过程。使用计算机方法减少了误差，能够制作出比以前更小的修补板。通过实现更高的贴合精度，还能够进行设计更改。
