Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 9, Bologna, Italy.
Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.
Sci Rep. 2020 Aug 7;10(1):13317. doi: 10.1038/s41598-020-70107-w.
In orthognathic surgery, the use of patient-specific osteosynthesis devices is a novel approach used to transfer the virtual surgical plan to the patient. The aim of this study is to analyse the quality of mandibular anatomy reproduction using a mandible-first mandibular-PSI guided procedure on 22 patients. Three different positioning guide designs were compared in terms of osteosynthesis plate positioning and mandibular anatomical outcome. PSIs and positioning guides were designed according to virtual surgical plan and 3D printed using biocompatible materials. A CBCT scan was performed 1 month after surgery and postoperative mandibular models were segmented for comparison against the surgical plan. A precision comparison was carried out among the three groups. Correlations between obtained rami and plates discrepancies and between planned rami displacements and obtained rami discrepancies were calculated. Intraoperatively, all PSIs were successfully applied. The procedure was found to be accurate in planned mandibular anatomy reproduction. Different guide designs did not differ in mandibular outcome precision. Plate positional discrepancies influenced the corresponding ramus position, mainly in roll angle and vertical translation. Ramus planned displacement was found to be a further potential source of inaccuracy, possibly due to osteosynthesis surface interference.
在正颌手术中，使用患者特异性骨结合装置是一种将虚拟手术计划转移到患者身上的新方法。本研究旨在分析使用下颌第一下颌 PSI 引导程序对 22 名患者的下颌解剖结构的复制质量。在骨结合板定位和下颌解剖学结果方面，比较了三种不同的定位引导设计。PSIs 和定位引导根据虚拟手术计划设计，并使用生物相容性材料 3D 打印。术后 1 个月进行 CBCT 扫描，并对术后下颌模型进行分割，与手术计划进行比较。对三组进行了精度比较。计算了获得的髁突和钢板差异之间以及计划的髁突移位与获得的髁突差异之间的相关性。所有 PSI 都在手术中成功应用。发现该程序在计划的下颌解剖结构复制方面非常准确。不同的引导设计在下颌结果的精度上没有差异。钢板位置的差异会影响相应的髁突位置，主要是在滚动角度和垂直平移方面。髁突计划的移位被认为是另一个潜在的不准确来源，可能是由于骨结合表面的干扰。
