The State Key Laboratory of Oral Diseases and Faculty, Orthognathic Surgery, West China College of Stomatology, Sichuan University, Chengdu, China.
Oral Surg Oral Med Oral Pathol Oral Radiol. 2012 Mar;113(3):356-61. doi: 10.1016/j.tripleo.2011.03.034.
Fracture or defect of the mandible is a serious complication of mandibular angleplasty, and precise reconstruction for such defect is still a huge challenge. This case report provides a new method based on CAD/CAM and rapid prototyped titanium for individual design, fabrication, and implantation of a mandibular ramus and angle. A 25-year-old woman with a square-shaped face, who had undergone mandibular outer cortex split ostectomy (MOCSO) 3 months earlier, was afflicted by a series of symptoms: asymmetric face, collapse of the right face, masticatory problems, deviation during mouth opening, malocclusion, and TMJ clicks. These symptoms were caused by unintentional removal of the fractured ramus during MOCSO. By means of CT scan data, rapid prototyping, reverse engineering, 3D display, and CAD/CAM, the individualized titanium implant was designed and fabricated. The 3D demo system of operative scheme demonstrated the operative procedure, and determined the position of the implant so as to obtain a perfect fit. Postoperatively, the patient regained satisfactory morphologic symmetry, facial appearance, occlusion, and TMJ functions.
下颌骨骨折或缺损是下颌角整形术的严重并发症，对于此类缺损的精确重建仍然是一个巨大的挑战。本病例报告提供了一种基于 CAD/CAM 和快速原型钛的新方法，用于下颌支和角的个体化设计、制作和植入。一位 25 岁的女性，因方形脸，3 个月前行下颌外皮质劈开截骨术（MOCSO），出现一系列症状：不对称的脸、右侧脸塌陷、咀嚼问题、开口时偏斜、咬合不正和 TMJ 弹响。这些症状是由于 MOCSO 过程中意外切除了骨折的下颌支。通过 CT 扫描数据、快速原型制作、逆向工程、3D 显示和 CAD/CAM，设计和制作了个体化钛植入物。手术方案的 3D 演示系统展示了手术过程，并确定了植入物的位置，以获得完美的适配。术后，患者恢复了满意的形态对称性、面部外观、咬合和 TMJ 功能。
