Azuma Masaki, Yanagawa Toru, Ishibashi-Kanno Naomi, Uchida Fumihiko, Ito Takaaki, Yamagata Kenji, Hasegawa Shogo, Sasaki Kaoru, Adachi Koji, Tabuchi Katsuhiko, Sekido Mitsuru, Bukawa Hiroki
Department of Oral and Maxillofacial Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan.
Head Face Med. 2014 Oct 23;10:45. doi: 10.1186/1746-160X-10-45.
Recently, medical rapid prototyping (MRP) models, fabricated with computer-aided design and computer-aided manufacture (CAD/CAM) techniques, have been applied to reconstructive surgery in the treatment of head and neck cancers. Here, we tested the use of preoperatively manufactured reconstruction plates, which were produced using MRP models. The clinical efficacy and esthetic outcome of using these products in mandibular reconstruction was evaluated.
A series of 28 patients with malignant oral tumors underwent unilateral segmental resection of the mandible and simultaneous mandibular reconstruction. Twelve patients were treated with prebent reconstruction plates that were molded to MRP mandibular models designed with CAD/CAM techniques and fabricated on a combined powder bed and inkjet head three-dimensional printer. The remaining 16 patients were treated using conventional reconstruction methods. The surgical and esthetic outcomes of the two groups were compared by imaging analysis using post-operative panoramic tomography.
The mandibular symmetry in patients receiving the MRP-model-based prebent plates was significantly better than that in patients receiving conventional reconstructive surgery.
Patients with head and neck cancer undergoing reconstructive surgery using a prebent reconstruction plate fabricated according to an MRP mandibular model showed improved mandibular contour compared to patients undergoing conventional mandibular reconstruction. Thus, use of this new technology for mandibular reconstruction results in an improved esthetic outcome with the potential for improved quality of life for patients.
近年来,采用计算机辅助设计和计算机辅助制造(CAD/CAM)技术制作的医学快速成型(MRP)模型已应用于头颈部癌症治疗的重建手术。在此,我们测试了术前使用MRP模型制作的重建板的应用情况。评估了在颌骨重建中使用这些产品的临床疗效和美学效果。
28例口腔恶性肿瘤患者接受了下颌骨单侧节段性切除及同期颌骨重建。12例患者使用根据CAD/CAM技术设计的MRP下颌模型预弯的重建板进行治疗,这些重建板在粉末床和喷墨头组合的三维打印机上制作。其余16例患者采用传统重建方法治疗。通过术后全景断层扫描成像分析比较两组的手术和美学效果。
接受基于MRP模型预弯板治疗的患者下颌对称性明显优于接受传统重建手术的患者。
与接受传统下颌骨重建的患者相比,使用根据MRP下颌模型制作的预弯重建板进行重建手术的头颈癌患者下颌轮廓得到改善。因此,将这项新技术用于下颌骨重建可改善美学效果,有可能提高患者的生活质量。