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用于下颌第三磨牙深度阻生拔除术的计算机辅助设计/计算机辅助制造切割导板

Computer-Aided Design/Computer-Aided Manufacturing Cutting Guides for Odontectomy of Deeply Impacted Mandibular Third Molars.

作者信息

Ahmed Mamdouhh, Salah Mariam Kamel, Khairy Nesrine

机构信息

Faculty of Dentistry, Cairo University, Oral and Maxillofacial Department 11 Al Saraya, Al Manial, Giza Governorate 11553, Egypt.

出版信息

Open Access Maced J Med Sci. 2018 Dec 19;6(12):2395-2401. doi: 10.3889/oamjms.2018.371. eCollection 2018 Dec 20.

DOI:10.3889/oamjms.2018.371
PMID:30607200
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6311491/
Abstract

AIM

To evaluate a new technique for surgical removal of deeply impacted mandibular third molars (DIMTM), using computer-guided cutting guide to maintain inferior alveolar nerve (IAN) integrity and the covering buccal bone.

PATIENTS AND METHODS

Eighteen cases indicated for removal of DIMTM. Cone-beam Computed Tomography (CBCTs) used to determine the tooth's relation to the IAN. Computer-guided software used for fabrication of surgical cutting guide stent to expose the impacted tooth and repositioning of bone after odontectomy without fixation. Clinical assessment included a neurosensory deficit of IAN, pain using a visual analogue scale (VAS), facial swelling, and maximal mouth opening (MMO). CBCTs were taken immediately and six months postoperatively to evaluate position and healing of bone.

RESULTS

None of the patients showed a permanent neurological deficit of IAN while all patients showed normal parameters of pain, facial swelling and MMO.

CONCLUSION

this technique has shown the accurate determination of the bony window cuts with subsequent preservation of IAN and external oblique ridge.

摘要

目的

评估一种使用计算机引导切割导板来维持下牙槽神经（IAN）完整性和颊侧覆盖骨的手术切除深部下颌阻生第三磨牙（DIMTM）的新技术。

患者与方法

18例需切除DIMTM的病例。使用锥形束计算机断层扫描（CBCT）确定牙齿与IAN的关系。使用计算机引导软件制作手术切割导板支架，以暴露阻生牙并在拔牙后重新定位骨组织，无需固定。临床评估包括IAN的神经感觉功能缺损、使用视觉模拟量表（VAS）评估的疼痛、面部肿胀和最大开口度（MMO）。在术后即刻和术后6个月拍摄CBCT，以评估骨组织的位置和愈合情况。

结果

所有患者均未出现IAN永久性神经功能缺损，且所有患者的疼痛、面部肿胀和MMO参数均正常。

结论

该技术已显示出能准确确定骨窗切口，随后可保留IAN和外斜线。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a780/6311491/3cf46f79d261/OAMJMS-6-2395-g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a780/6311491/b054ad73fca9/OAMJMS-6-2395-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a780/6311491/6a427d53e59a/OAMJMS-6-2395-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a780/6311491/a56f839416cd/OAMJMS-6-2395-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a780/6311491/b4d6793ff4b5/OAMJMS-6-2395-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a780/6311491/562f0ea9db29/OAMJMS-6-2395-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a780/6311491/3376b70ca4d1/OAMJMS-6-2395-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a780/6311491/8e9a571c5b62/OAMJMS-6-2395-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a780/6311491/3cf46f79d261/OAMJMS-6-2395-g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a780/6311491/b054ad73fca9/OAMJMS-6-2395-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a780/6311491/6a427d53e59a/OAMJMS-6-2395-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a780/6311491/a56f839416cd/OAMJMS-6-2395-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a780/6311491/b4d6793ff4b5/OAMJMS-6-2395-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a780/6311491/562f0ea9db29/OAMJMS-6-2395-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a780/6311491/3376b70ca4d1/OAMJMS-6-2395-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a780/6311491/8e9a571c5b62/OAMJMS-6-2395-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a780/6311491/3cf46f79d261/OAMJMS-6-2395-g008.jpg

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