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颏成形术牙支持式手术导板的设计与制造

Design and manufacture of dental-supported surgical guide for genioplasty.

作者信息

Wang Li-Dong, Ma Wen, Fu Shuai, Zhang Chang-Bin, Cui Qing-Ying, Peng Can-Bang, Li Ming

机构信息

Department of Oral and Maxillofacial Surgery, Affiliated Stomatological Hospital of Kunming Medical University, Kunming, China.

出版信息

J Dent Sci. 2021 Jan;16(1):417-423. doi: 10.1016/j.jds.2020.07.017. Epub 2020 Aug 22.

Abstract

BACKGROUND/PURPOSE: Genioplasty were used widely to correct chin deformities. The purpose of this study was to design and manufacture a dental-supported surgical guide for genioplasty surgery and assess for surgical accuracy.

MATERIALS AND METHODS

eleven patients with chin deformities were treated in this study. The computed tomography (CT) data of the patient's skull and the digital dental models of stone dental models were acquired preoperatively. For each patient, a virtual three-dimensional (3D) model of the skull was constructed and enhanced with digital dental models. A surgical simulation was then performed using computer-aided surgical simulation (CASS) technology based on clinical examination and 3D cephalometry. The surgery was simulated preoperatively which allowed the design of a cutting guide and a dental-supported repositioning guide for genioplasty, which was then 3D-printed and used during operation after disinfection. After surgery, the outcome was evaluated by superimposing the postoperative CT model onto the preoperative model, recording the linear and angular deviation of landmarks and plane, then measuring the differences between the planned and actual outcomes.

RESULTS

The osteotomy and repositioning were successfully performed as planned using surgical guides. No inferior alveolar nerve damage was seen in this study. The dental-supported surgical guide showed excellent accuracy, with the largest differences between the planned and the postoperative chin segment being 0.9 mm and 3.2°.

CONCLUSION

The dental-supported surgical guide designed preoperatively provided a reliable method of transfer genioplasty planning. This can assist surgeons in accurately performing osteotomy and repositioning bone segments during a genioplasty.

摘要

背景/目的:颏成形术被广泛用于矫正颏部畸形。本研究的目的是设计并制造一种用于颏成形术的牙支持式手术导板,并评估其手术准确性。

材料与方法

本研究纳入11例颏部畸形患者。术前获取患者颅骨的计算机断层扫描(CT)数据以及石膏牙模型的数字化牙模型。对于每位患者,构建颅骨的虚拟三维(3D)模型并用数字化牙模型进行增强。然后基于临床检查和3D头影测量,使用计算机辅助手术模拟(CASS)技术进行手术模拟。术前进行手术模拟,据此设计颏成形术的截骨导板和牙支持式复位导板,然后进行3D打印并在消毒后用于手术。术后,通过将术后CT模型与术前模型叠加,记录标志点和平面的线性及角度偏差,然后测量计划结果与实际结果之间的差异来评估手术效果。

结果

使用手术导板按计划成功完成了截骨和复位。本研究中未观察到下牙槽神经损伤。牙支持式手术导板显示出极佳的准确性,计划的颏部节段与术后的最大差异为0.9毫米和3.2°。

结论

术前设计的牙支持式手术导板为颏成形术计划的转移提供了一种可靠方法。这可协助外科医生在颏成形术中准确地进行截骨和骨段复位。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/97ca/7770303/d0d3619acf89/gr1.jpg

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