Suojanen Juho, Leikola Junnu, Stoor Patricia
Departments of Oral and Maxillo-Facial Diseases (Head: Risto Kontio, MD, DDS, PhD), University of Helsinki and Helsinki University Hospital, Haartmaninkatu 4E, 00029 HUS, Helsinki, Finland.
Cleft Lip and Palate and Craniofacial Centre (Head: Hannu Kuokkanen, MD, PhD), Helsinki University Hospital, Sibeliuksenkatu 10, 00029 HUS, Finland.
J Craniomaxillofac Surg. 2017 Jun;45(6):990-994. doi: 10.1016/j.jcms.2017.02.021. Epub 2017 Mar 3.
Virtual surgery combined with patient-specific saw and drill guides and osteosynthesis materials are rapidly spreading from reconstructive surgery to orthognathic surgery. Most commercial partners are already providing computer-aided design and computer-aided manufacture (CAD/CAM) wafers and patient-specific saw guides. Clear benefits have been demonstrated for custom-made drill guides combined with individually designed three-dimensional (3D) printed patient-specific implants (PSI) as a reposition and fixation system in Le Fort I osteotomy.
We treated 30 patients who underwent bilateral sagittal split osteotomy (BSSO) due to class II dento-skeletal deformities with the additional use of drill guides combined with PSI as a fixation and positioning system.
The PSIs fitted bilaterally with total precision in 11 of the 30 patients. In 17 patients, the PSIs were used with some modifications. In 2 of 30 patients, the PSIs could not be used as a fixation due to misfit.
Due to unpredictable fitting, the use of PSIs with drill guides alone in BSSO without wafers cannot be recommended. Further studies are needed to evaluate the interfering parts, which seem to be related to condylar positioning and bony interferences at the osteotomy sites.
虚拟手术结合患者特异性锯片和钻孔导向器以及接骨材料正迅速从重建手术扩展到正颌手术。大多数商业合作伙伴已经在提供计算机辅助设计和计算机辅助制造（CAD/CAM）薄片以及患者特异性锯片导向器。在Le Fort I截骨术中，定制钻孔导向器与单独设计的三维（3D）打印患者特异性植入物（PSI）作为一种复位和固定系统，已显示出明显的优势。
我们治疗了30例因II类牙颌面畸形接受双侧矢状劈开截骨术（BSSO）的患者，额外使用钻孔导向器与PSI作为固定和定位系统。
30例患者中有11例双侧PSI完全精确适配。17例患者使用的PSI进行了一些修改。30例患者中有2例因适配不佳，PSI无法用作固定。
由于适配情况不可预测，不建议在没有薄片的BSSO中单独使用带钻孔导向器的PSI。需要进一步研究以评估干扰部位，这些部位似乎与髁突定位和截骨部位的骨干扰有关。
