Yamaguchi Yoshihiro, Yamauchi Kensuke, Suzuki Hikari, Saito Shizu, Nogami Shinnosuke, Takahashi Tetsu
Department of Oral and Maxillofacial Surgery, Tohoku University, Postgraduate School of Dentistry, Miyagi, Japan.
J Craniofac Surg. 2020 Jun;31(4):976-979. doi: 10.1097/SCS.0000000000006305.
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.
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).
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.
Placement of CAD/CAM splint allowed highly accurate repositioning; the accuracy exceeded that afforded by conventional model surgery using a facebow and articulator.
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。
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)。
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。
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。