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Ⅲ类骨性错颌畸形患者牙合架模型手术与虚拟手术设计术后及随访准确性的比较

Comparison of the postoperative and follow-up accuracy of articulator model surgery and virtual surgical planning in skeletal class III patients.

作者信息

Xu R, Ye N, Zhu S, Shi B, Li J, Lai W

机构信息

State Key Laboratory of Oral Diseases & National Clinical Research Centre for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, 14 Ren Min Nan Road, Chengdu, 610041, PR China; State Key Laboratory of Oral Diseases & National Clinical Research Centre for Oral Diseases, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, 14 Ren Min Nan Road, Chengdu, 610041, PR China.

Department of Orthodontics, Ninth People's Hospital Affiliated to Shanghai Jiao Tong University, School of Medicine, No. 639 Zhizaoju Road, Shanghai, PR China.

出版信息

Br J Oral Maxillofac Surg. 2020 Oct;58(8):933-939. doi: 10.1016/j.bjoms.2020.04.032. Epub 2020 May 20.

Abstract

The aim of this study was to evaluate the postoperative and follow-up accuracy of using an intermediate occlusal splint between articulator model surgery (AMS) and virtual surgical planning (VSP) in double-jaw operations. Thirty skeletal class III patients were randomly allocated to have AMS or VSP. In the AMS group surgical planning was done through conventional articulator model surgery, and an intermediate occlusal splint made of acrylic resin was used. In the VSP group the surgical simulation was done virtually, and the same intermediate splint was used in the software and then fabricated using rapid prototyping technology. Preoperatively, one week postoperatively, and 1∼2-years later we obtained follow-up cone-beam computed tomographic (CT) images of each patient. Absolute linear differences between planned and actual outcomes, as well as planned and follow-up outcomes, were evaluated. There was no significant difference in either postoperative accuracy or follow-up accuracy between the methods, and there was no significant difference in the rate of skeletal relapse. Planning transfer by intermediate splint might therefore be the dominant factor in the final inaccuracies. The potentially greater accuracy of VSP may be realised with the help of new positioning devices instead of an intermediate splint.

摘要

本研究的目的是评估在双颌手术中,在牙合架模型手术(AMS)和虚拟手术规划(VSP)之间使用中间牙合板的术后及随访准确性。30例骨骼Ⅲ类患者被随机分配接受AMS或VSP。在AMS组,通过传统牙合架模型手术进行手术规划,并使用丙烯酸树脂制作中间牙合板。在VSP组,通过虚拟方式进行手术模拟,并在软件中使用相同的中间牙合板,然后采用快速成型技术制作。术前、术后1周以及1至2年后,我们获取了每位患者的随访锥形束计算机断层扫描(CT)图像。评估了计划结果与实际结果之间以及计划结果与随访结果之间的绝对线性差异。两种方法在术后准确性或随访准确性方面均无显著差异,骨骼复发率也无显著差异。因此,通过中间牙合板进行的计划转移可能是最终不准确性的主要因素。借助新的定位装置而非中间牙合板,VSP潜在的更高准确性可能得以实现。

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