State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Dept. of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, PR China.
State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Dept. of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, PR China; Department of Stomatology, Taikang Xianlin Drum Tower Hospital, Nanjing, PR China.
J Craniomaxillofac Surg. 2020 Jan;48(1):1-8. doi: 10.1016/j.jcms.2019.01.039. Epub 2019 Feb 1.
The treatment of hemimandibular hyperplasia (HH) is difficult by performing condylectomy and orthognathic surgery in one stage. This study investigated the clinical feasibility of treating HH with computer-aided design and computer-aided manufacturing (CAD/CAM) cutting and drilling guides and the pre-bent titanium plates to improve the accuracy of operation to avoid condyle reconstruction.
12 patients diagnosed with HH were included in this study from 2014 to 2018. Conservative condylectomy and bimaxillary orthognathic surgery were performed in all patients. The CAD/CAM cutting and drilling guides and the pre-bent titanium plates were used to guide surgeries. Follow-up and radiographic examinations were performed. The difference between virtually simulated and postoperative models was measured.
All patients got satisfactory and stable results, without complications or obvious relapse during follow-up. Occlusion relationship, temporomandibular joint function and facial symmetry were improved obviously after surgery. Comparison between simulated plans and actual postoperative outcomes showed that the surgical plans were transferred accurately.
CAD/CAM cutting and drilling guides and the pre-bent titanium plates described in this paper can help transferring the results from computer simulation to the operating room accurately. Conservative condylectomy can be operated exactly matching bimaxillary orthognathic surgery for treating HH, avoiding condyle reconstruction.
通过在一期手术中进行髁突切除术和正颌手术来治疗下颌骨偏位症（HH）具有一定难度。本研究旨在探讨应用计算机辅助设计和计算机辅助制造（CAD/CAM）切割导板和预弯钛板治疗 HH 的临床可行性，以提高手术准确性，避免髁突重建。
2014 年至 2018 年期间，共纳入 12 例 HH 患者。所有患者均行保守性髁突切除术和双颌正颌手术。采用 CAD/CAM 切割导板和预弯钛板进行手术引导。术后进行随访和影像学检查，并测量虚拟模拟与术后模型之间的差异。
所有患者均获得满意且稳定的效果，随访期间无并发症或明显复发。术后患者的咬合关系、颞下颌关节功能和面部对称性明显改善。模拟计划与实际术后结果的比较表明，手术计划准确转移。
本文描述的 CAD/CAM 切割导板和预弯钛板可帮助将计算机模拟结果准确转移至手术室。保守性髁突切除术可以与双颌正颌手术精确匹配，用于治疗 HH，避免髁突重建。
