Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University, Seoul, Republic of Korea.
Department of Oral and Maxillofacial Surgery, National Health Insurance Service Ilsan Hospital, Goyang, Republic of Korea.
Head Face Med. 2020 Nov 26;16(1):31. doi: 10.1186/s13005-020-00241-3.
A new distraction osteogenesis assembly system comprising a fully customized CAD/CAM-based fixation unit and ready-made distraction unit was developed. The aim of this study was to introduce our new distraction system and to evaluate its accuracy level in a sampled mandibular distraction osteogenesis.
Our system consists of a fully customized CAD/CAM-based fixation plate unit with two plates for each moving and anchoring part, and a ready-made distraction unit with attachment slots for fixation plates. The experimental distractions were performed on 3D-printed mandibles for one control and two experimental groups (N = 10 for each group). All groups had reference bars on the chin region and teeth to measure distraction accuracy. The control group had the classical ready-made distraction system, and experimental groups 1 and 2 were fitted with our new distraction assembly using a different distractor-positioning guide design. All distracted experimental mandibles were scanned by CT imaging, then superimposed on a 3D simulation to get their discrepancy levels.
The measured 3D distances between the reference landmarks of the surgical simulations and the experimental surgeries for the three groups were significantly different (p < 0.0001) by statistical analysis. The errors were greater in the control group (with a total average of 19.18 ± 3.73 mm in 3D distance between the simulated and actual reference points) than those in the two experimental groups (with an average of 3.68 ± 1.41 mm for group 1 and 3.07 ± 1.39 mm for group 2). The customized distraction assembly with 3D-printed bone plate units in group 1 and 2, however, did not show any significant differences between simulated and actual distances (p > 0.999).
Our newly-developed distraction assembly system with CAD/CAM plate for the distraction osteogenesis of the mandible produced a greater level of accuracy than that of a conventional distraction device. The system appears to address existing shortcomings of conventional distraction devices, including inaccuracy in vector-controlled movement of the system. However, it also needs to be further developed to address the requirements and anatomical characteristics of specific regions.
开发了一种新的牵张成骨装配系统，包括一个完全定制的基于 CAD/CAM 的固定单元和现成的牵张单元。本研究的目的是介绍我们的新牵张系统，并评估其在抽样下颌骨牵张成骨中的精确水平。
我们的系统由一个完全定制的基于 CAD/CAM 的固定板单元组成，每个移动和锚固部分有两个板，以及一个带有固定板的现成的牵张单元。实验性牵张在 3D 打印的下颌骨上进行，对照组和实验组各 10 例（每组）。所有组在颏部和牙齿上都有参考棒来测量牵张精度。对照组采用经典的现成牵张系统，实验组 1 和 2 采用不同的牵张定位器设计，采用我们的新型牵张组件。所有牵张实验性下颌骨均通过 CT 成像扫描，然后叠加到 3D 模拟上以获得它们的差异水平。
通过统计学分析，三组手术模拟和实验手术的参考标志点之间的测量 3D 距离差异显著（p<0.0001）。对照组的误差较大（模拟和实际参考点之间的 3D 距离总平均值为 19.18±3.73mm），实验组 1 和实验组 2 的误差平均值分别为 3.68±1.41mm 和 3.07±1.39mm。然而，在实验组 1 和 2 中，使用 3D 打印骨板单元的定制牵张组件在模拟和实际距离之间没有显示出任何显著差异（p>0.999）。
与传统的牵张设备相比，用于下颌骨牵张成骨的新开发的 CAD/CAM 板牵张组件系统具有更高的精确水平。该系统似乎解决了传统牵张设备的现有缺点，包括系统向量控制运动的不准确性。然而，它还需要进一步开发，以满足特定区域的要求和解剖特征。
