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计算机辅助设计和制造预弯钛板的切割和钻孔引导器可提高骨骼 III 类错畸形的手术准确性。

Computer-Aided Design and Manufacturing Cutting and Drilling Guides with Prebent Titanium Plates Improve Surgical Accuracy of Skeletal Class III Malocclusion.

机构信息

From the Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University; and the Department of Oral and Maxillofacial Surgery, Shanghai Stomatological Hospital, Fudan University.

出版信息

Plast Reconstr Surg. 2020 May;145(5):963e-974e. doi: 10.1097/PRS.0000000000006794.

Abstract

BACKGROUND

The aim of this study was to evaluate the effects of the use of computer-aided design and manufacturing cutting and drilling guides with prebent titanium plates for the correction of skeletal class III malocclusion.

METHODS

In this prospective, randomized, controlled clinical trial, 46 patients with skeletal class III malocclusion were randomly assigned into two groups. The patients underwent bimaxillary surgery with computer-aided design and manufacturing cutting and drilling guides with prebent titanium plates (experimental group) or computer-aided design and manufacturing splints (control group). Preoperative and postoperative imaging data were collected and then analyzed using Mimics Research 19.0, Geomagic Studio, and IBM SPSS Version 21.0.

RESULTS

Deformity evaluation and posttreatment assessment were performed for all patients. The experimental group had fewer postoperative complications. Comparison of the linear and angular differences to facial reference planes revealed more accurate repositioning of the mandible and condyles in the experimental group, although the position of several landmarks still requires small adjustments.

CONCLUSION

Computer-aided design and manufacturing cutting and drilling guides with prebent titanium plates effectively corrected skeletal class III malocclusion, providing positional control of segments with reasonable surgical accuracy.

CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, II.

摘要

背景

本研究旨在评估使用计算机辅助设计和制造预弯钛板切割和钻孔引导器治疗骨性 III 类错颌畸形的效果。

方法

这是一项前瞻性、随机、对照临床试验,46 例骨性 III 类错颌畸形患者被随机分为两组。两组患者均接受双颌手术,使用计算机辅助设计和制造预弯钛板切割和钻孔引导器(实验组)或计算机辅助设计和制造夹板(对照组)。收集术前和术后的影像学数据,然后使用 Mimics Research 19.0、Geomagic Studio 和 IBM SPSS Version 21.0 进行分析。

结果

对所有患者进行了畸形评估和治疗后评估。实验组术后并发症较少。与面部参考平面的线性和角度差异比较显示,实验组下颌骨和髁突的重新定位更准确,但几个标志点的位置仍需要进行微调。

结论

使用计算机辅助设计和制造预弯钛板切割和钻孔引导器可有效纠正骨性 III 类错颌畸形,为手术提供合理的精确性,实现对各部位的位置控制。

临床问题/证据水平:治疗,II 级。

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