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在双颌正颌手术中,通过手术模拟获得的计算机辅助设计/计算机辅助制造中间夹板对上颌位置的准确性

The Accuracy of Maxillary Position Using a Computer-Aided Design/Computer-Aided Manufacturing Intermediate Splint Derived Via Surgical Simulation in Bimaxillary Orthognathic Surgery.

作者信息

Yamaguchi Yoshihiro, Yamauchi Kensuke, Suzuki Hikari, Saito Shizu, Nogami Shinnosuke, Takahashi Tetsu

机构信息

Department of Oral and Maxillofacial Surgery, Tohoku University, Postgraduate School of Dentistry, Miyagi, Japan.

出版信息

J Craniofac Surg. 2020 Jun;31(4):976-979. doi: 10.1097/SCS.0000000000006305.

Abstract

PURPOSE

The purpose of this study was to assess the clinical interventions and the accuracy of maxillary reposition using a computer-aided design/computer-aided manufacturing (CAD/CAM) splint derived via surgical simulation.

MATERIALS AND METHODS

The retrospective study comprised 24 patients who underwent bimaxillary surgery. The patients were assigned to 1 of 2 groups by a way of maxillary repositioning. One group received conventional intermediate wafers and the other CAD/CAM wafers during Le Fort I osteotomy. We recorded operation time, blood loss, the operative accuracy. Accuracy was analyzed by 3-dimensional computed tomography images before and immediately after the operation. The evaluation points were the right maxillary first incisor (U1), the right maxillary second molar (M2-right), and the left maxillary second molar (M2-left).

RESULTS

The 2 groups did not differ significantly in operation time and blood losses. The vertical axis of U1 data differed significantly between the 2 groups (P = 0.008). None of the horizontal, vertical, or anteroposterior axis of M2-right data differed significantly, and anteroposterior axis of M2-left data differed significantly (P = 0.0296). The CAD/CAM group 3-dimensional distance errors were less than those of the conventional group for all points.

CONCLUSION

Placement of CAD/CAM splint allowed highly accurate repositioning; the accuracy exceeded that afforded by conventional model surgery using a facebow and articulator.

摘要

目的

本研究旨在评估使用通过手术模拟获得的计算机辅助设计/计算机辅助制造(CAD/CAM)夹板进行上颌骨复位的临床干预措施及准确性。

材料与方法

这项回顾性研究纳入了24例行双颌手术的患者。根据上颌骨复位方式将患者分为2组。一组在Le Fort I截骨术中使用传统中间薄蜡片,另一组使用CAD/CAM薄蜡片。我们记录了手术时间、失血量和手术准确性。通过术前及术后即刻的三维计算机断层扫描图像分析准确性。评估点为右上颌第一切牙(U1)、右上颌第二磨牙(M2-右)和左上颌第二磨牙(M2-左)。

结果

两组在手术时间和失血量方面无显著差异。两组U1数据的垂直轴差异有统计学意义(P = 0.008)。M2-右数据的水平、垂直或前后轴均无显著差异,M2-左数据的前后轴差异有统计学意义(P = 0.0296)。CAD/CAM组所有点的三维距离误差均小于传统组。

结论

放置CAD/CAM夹板可实现高度精确的复位;其准确性超过了使用面弓和牙合架的传统模型手术。

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