Ren W H, Gao L, Li S M, Li F, Zhi Y, Song J Z, Wang Q B, Xue L F, Qu Z G, Zhi K Q
Department of Oral and Maxillofacial Surgery, the Affiliated Hospital of Qingdao University, Qingdao 255666, China.
Zhonghua Yi Xue Za Zhi. 2018 Sep 4;98(33):2666-2670. doi: 10.3760/cma.j.issn.0376-2491.2018.33.011.
To evaluate the use of virtual planning and 3D printing modeling in mandibular reconstruction and compare the operation time and surgical outcome of this technique with conventional method. Between June 2013 and June 2017, A total of 18 patients underwent the mandibular reconstruction with fibula free flap in the Affiliated Hospital of Qingdao University.Among 18 patients, there were 11 males and 7 females with an average age of 36.5 years (21-73 years). Nine patients underwent vascularized fibula flap mandibular reconstruction using virtual planning and 3D printing modeling.Titanium plates were pre-bent using the models and cutting guides which were used for osteotomies.Another 9 patients who underwent mandibular reconstruction using fibula flap without aid of virtual planning and 3D printing models were selected as control group. The operation time was recorded and compared in two groups. Accuracy of reconstruction was measured by superimposing the preoperative image onto the postoperative image of mandible. The selected bony landmark, distance and angle were measured. The mean total operation time were 4.7-6.2(5.5±0.5) h in computer-assisted group and 5.6-7.5(6.6±0.7) h in conventional group, respectively. The operation time was shorter in computer-assisted group. The difference between the preoperative and postoperative intercondylar distances, intergonial angle distances, anteroposterior distances were(2.6±1.4)vs(4.4±1.6)mm, (2.9±1.2)vs(4.7±1.7)mm, (4.2±1.4) vs(5.9±1.8)mm in the computer-assisted and conventional group, respectively. The differences between the preoperative and postoperative mandible were smaller in the computer-assisted group. Virtual planning and 3D printing modeling have the potential to increase mandibular reconstruction accuracy and reduce operation time. We believe that this technology for mandibular reconstruction in selected patients can significantly improve the quality of reconstruction.
评估虚拟规划和3D打印建模在下颌骨重建中的应用，并将该技术的手术时间和手术结果与传统方法进行比较。2013年6月至2017年6月，青岛大学附属医院共有18例患者接受了游离腓骨瓣下颌骨重建手术。18例患者中，男性11例，女性7例，平均年龄36.5岁（21 - 73岁）。9例患者采用虚拟规划和3D打印建模进行带血管腓骨瓣下颌骨重建。使用模型和用于截骨的切割导板对钛板进行预弯。另外9例未借助虚拟规划和3D打印模型而采用腓骨瓣进行下颌骨重建的患者作为对照组。记录并比较两组的手术时间。通过将术前图像与术后下颌骨图像叠加来测量重建的准确性。测量选定的骨性标志、距离和角度。计算机辅助组的平均总手术时间为4.7 - 6.2（5.5±0.5）小时，传统组为5.6 - 7.5（6.6±0.7）小时。计算机辅助组的手术时间更短。计算机辅助组和传统组术前与术后髁间距离、下颌角间距离、前后距离的差值分别为（2.6±1.4）对（4.4±1.6）mm、（2.9±1.2）对（4.7±1.7）mm、（4.2±1.4）对（5.9±1.8）mm。计算机辅助组术前与术后下颌骨的差异更小。虚拟规划和3D打印建模有可能提高下颌骨重建的准确性并减少手术时间。我们认为，这项用于特定患者下颌骨重建的技术可以显著提高重建质量。
