Liu Yanpu, Gong Zhengyu, He Lisheng, Zhao Jilong, Yu Bai, Zhang Haixia
Department of Oral and Maxillofacial Surgery, Stomatological College, Fourth Military Medical Univercity, Xi'an Shaanxi, PR China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2005 Oct;19(10):803-6.
To build up a new contour and functional reconstruction technique of mandibular defects with rapid prototyping and reverse engineering technique.
From April 2002 to August 2004, 4 cases of mandibular defects due to resection of large mandible lesion were treated. Of 4 patients, there were 3 females and 1 male, with an age range of 21-42 years, which underwent secondary operation and presented a deviation as mandibular movement. The opening-mouth extent was 1.8-2.5 cm (2.2 cm on average). The data of defects area were renewed with Mimics and Geomagic Studio software; and the titanium reconstructive frame was designed and manufactured with rapid prototyping technique. Defect were reconstructed by using CT digital data of patients.
The CT data could be used by image software directly. The implant design could be completed by computer-aimed design (CAD) / computer-aided manufacture (CAM). The resin model and titanium frame were manufactured accurately by RP technique. Four patients achieved one stage healing. After a follow-up of 3 months to 2 years, large mandibular defect was reconstructed satisfactorily and the opening-mouth extent was 3.0-3.4 cm (3.2 cm on average). The occluding relation was normal. The implant denture was put on and the mastication function was good in 1 case.
Individual design and repair of large mandibular defect with CAD/CAM techniques is worth extending application clinically. It is a simple and accurate method.
运用快速成型及逆向工程技术构建下颌骨缺损新的外形及功能重建技术。
2002年4月至2004年8月，对4例因下颌骨巨大病变切除导致下颌骨缺损的患者进行治疗。4例患者中，女性3例，男性1例，年龄21 - 42岁，均接受二期手术，存在下颌运动偏斜。张口度为1.8 - 2.5厘米（平均2.2厘米）。利用Mimics和Geomagic Studio软件更新缺损区域数据；采用快速成型技术设计并制造钛重建框架。依据患者的CT数字数据进行缺损重建。
CT数据可直接被图像软件使用。通过计算机辅助设计（CAD）/计算机辅助制造（CAM）完成植入物设计。采用快速成型技术精确制造树脂模型和钛框架。4例患者均一期愈合。随访3个月至2年，下颌骨巨大缺损重建效果满意，张口度为3.0 - 3.4厘米（平均3.2厘米）。咬合关系正常。1例患者佩戴种植义齿，咀嚼功能良好。
运用CAD/CAM技术对下颌骨巨大缺损进行个体化设计与修复值得在临床推广应用。这是一种简单且精确的方法。
