Tian Taoran, Zhang Tao, Ma Quanquan, Zhang Qi, Cai Xiaoxiao
Resident, State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan Province, China.
Professor, State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan Province, China.
J Oral Maxillofac Surg. 2017 Jul;75(7):1403.e1-1403.e10. doi: 10.1016/j.joms.2017.02.022. Epub 2017 Mar 7.
Although digital aids can help surgeons compensate for the shortcomings of traditional mandibular reconstruction techniques to perform surgery more precisely and effectively, the use of these digital techniques has often been fragmented, divided, and incomplete. This article describes the workflow of a fully digital mandibular reconstruction to explore the proper indications and discusses innovations based on the accuracy and effectiveness of digital techniques.
A restoration-oriented mandibular reconstruction was performed by applying different digital techniques. Preoperative virtual surgery and rapid prototyping were used to aid the vascularized iliac bone graft surgery, which offered a solid basis for the ensuing treatment. Subsequently, implant rehabilitation was accomplished with the assistance of computer-assisted design and manufacture, laser treatment, and selective laser melting techniques.
The workflow of the fully digital mandibular reconstruction successfully achieved a restoration-oriented treatment. These predictable, accurate, and effective digital techniques improved the consistency of pretreatment design and follow-up treatment. The treatment sequence achieved high predictability and reproducibility owing to the use of digital techniques.
This study shows that a digital workflow can be predictable, accurate, and effective, which suggests that it could be a valid digital protocol for developing a treatment sequence for patients with jaw defects caused by trauma, congenital anomalies, or mandibular tumor resection.
尽管数字辅助工具可帮助外科医生弥补传统下颌骨重建技术的不足,从而更精确、有效地进行手术,但这些数字技术的应用往往零散、割裂且不完整。本文描述了全数字化下颌骨重建的工作流程,以探索其合适的适应症,并基于数字技术的准确性和有效性讨论创新之处。
通过应用不同的数字技术进行以修复为导向的下颌骨重建。术前虚拟手术和快速成型技术用于辅助带血管蒂髂骨移植手术,为后续治疗提供了坚实基础。随后,在计算机辅助设计与制造、激光治疗和选择性激光熔化技术的协助下完成种植修复。
全数字化下颌骨重建的工作流程成功实现了以修复为导向的治疗。这些可预测、准确且有效的数字技术提高了术前设计与后续治疗的一致性。由于使用了数字技术,治疗过程具有高度的可预测性和可重复性。
本研究表明数字工作流程具有可预测性、准确性和有效性,这表明它可能是为因创伤、先天性畸形或下颌骨肿瘤切除导致颌骨缺损的患者制定治疗方案的有效数字协议。