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颏成形术精确复位仪及治疗复杂面部不对称的三维打印技术

The Precise Repositioning Instrument for Genioplasty and a Three-Dimensional Printing Technique for Treatment of Complex Facial Asymmetry.

机构信息

Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Jilin University, No.1500 Qinghua Road, Changchun, 130021, Jilin, China.

Life Science Research Center, Beihua University, Jilin City, China.

出版信息

Aesthetic Plast Surg. 2017 Aug;41(4):919-929. doi: 10.1007/s00266-017-0875-2. Epub 2017 Apr 13.

Abstract

BACKGROUND

Facial asymmetry is very common in maxillofacial deformities. It is difficult to achieve accurate reconstruction. With the help of 3D printing models and surgical templates, the osteotomy line and the amount of bone grinding can be accurate. Also, by means of the precise repositioning instrument, the repositioning of genioplasty can be accurate and quick. In this study, we present a three-dimensional printing technique and the precise repositioning instrument to guide the osteotomy and repositioning, and illustrate their feasibility and validity.

METHODS

Eight patients with complex facial asymmetries were studied. A precise 3D printing model was obtained. We made the preoperative design and surgical templates according to it. The surgical templates and precise repositioning instrument were used to obtain an accurate osteotomy and repositioning during the operation. Postoperative measurements were made based on computed tomographic data, including chin point deviation as well as the symmetry of the mandible evaluated by 3D curve functions.

RESULTS

All patients obtained satisfactory esthetic results, and no recurrences occurred during follow-up. The results showed that we achieved clinically acceptable precision for the mandible and chin. The mean and SD of ICC between R-Post and L-Post were 0.973 ± 0.007. The mean and SD of chin point deviation 6 months after the operation were 0.63 ± 0.19 mm.

CONCLUSION

The results of this study suggest that the three-dimensional printing technique and the precise repositioning instrument could aid in making better operation designs and more accurate manipulation in orthognathic surgery for complex facial asymmetry.

LEVEL OF EVIDENCE IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

摘要

背景

面部不对称在颌面部畸形中非常常见。很难实现准确的重建。借助 3D 打印模型和手术模板,可以精确地确定截骨线和骨磨量。此外,通过精确的复位器械,可以快速准确地实现下颌骨的复位。在本研究中,我们提出了一种 3D 打印技术和精确复位器械来指导截骨和复位,并说明了其可行性和有效性。

方法

研究了 8 例复杂面部不对称患者。获得了精确的 3D 打印模型。我们根据它进行了术前设计和手术模板制作。手术模板和精确复位器械用于在手术中获得精确的截骨和复位。术后根据 CT 数据进行测量,包括颏点偏差以及通过 3D 曲线函数评估的下颌骨对称性。

结果

所有患者均获得满意的美学效果,随访期间无复发。结果表明,我们实现了对下颌骨和颏部具有临床可接受精度的截骨和复位。术后 6 个月 R-Post 和 L-Post 之间的 ICC 均值和标准差为 0.973±0.007。术后 6 个月颏点偏差的均值和标准差为 0.63±0.19mm。

结论

本研究结果表明,3D 打印技术和精确复位器械可辅助进行更好的手术设计和更精确的操作,以治疗复杂的面部不对称。

证据水平 IV:本期刊要求作者为每篇文章分配一个证据水平。有关这些循证医学评级的完整描述,请参考目录或在线作者指南 www.springer.com/00266

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