Roy Chowdhury Sanjay Kumar, Shadamarshan Rengasayee Arunkumar, Krishnaprabhu Rajkumar
Oral and Maxillofacial Surgery, Command Military Dental Centre (Western Command), Chandimandir Cantt, India.
Oral and Maxillofacial Surgery, Vajra Corps Dental Unit, Opp Military Hospital, 144005 Jalandhar Cantt, India.
J Maxillofac Oral Surg. 2021 Mar;20(1):121-131. doi: 10.1007/s12663-020-01419-7. Epub 2020 Oct 16.
To assess the usefulness of 3D models for the surgical management of mandibular pathology requiring resection with continuity defects reconstructed using reconstruction plates.
A bidirectional study was conducted in 40 patients, 20 each in group 1 and 2. Group 1 included those patients taken up for resection with continuity defects and reconstruction using reconstruction plates without using 3D models and Group 2 included those patients managed similarly with 3D models. Pre-operative pathological model and mirrored model was fabricated for accurate placement and pre-bending of plates and determining the position and length of the screws. The level of understanding of the patients with regards to the diagnosis and extent of the disease (VAS 0-10), treatment planning (VAS 0-10), accuracy of fixation by a blinded surgeon (VAS 0-5), operative time, change in the mouth Opening, occlusal disturbance, implant-related complications was assessed as outcome measures and tested statistically.
The level of understanding of the patients with regards to the diagnosis and extent of the disease, treatment planning, operative time and accuracy of fixation was found to be statistically significant with superior performance in Group 2. No statistical significance was elicited in the change in mouth opening. No limitation in the mandibular range of movements and occlusal disturbance was found in any patient. No implant-related complications were found during the follow-up.
3D model fabrication can serve as a valuable adjunct in improving clinical outcomes with minimal operating time, increased patient compliance and radiological accuracy of fixation.
评估三维模型在需要使用重建钢板修复连续性缺损的下颌骨病变手术治疗中的作用。
对40例患者进行了一项双向研究,第1组和第2组各20例。第1组包括那些接受连续性缺损切除并用重建钢板修复但未使用三维模型的患者,第2组包括那些同样接受治疗但使用了三维模型的患者。制作术前病理模型和镜像模型,用于精确放置和预弯钢板以及确定螺钉的位置和长度。将患者对疾病诊断和范围的理解程度(视觉模拟评分0 - 10分)、治疗计划(视觉模拟评分0 - 10分)、由不知情的外科医生进行固定的准确性(视觉模拟评分0 - 5分)、手术时间、张口度变化、咬合紊乱、种植体相关并发症作为观察指标进行评估并进行统计学检验。
发现患者对疾病诊断和范围的理解程度、治疗计划、手术时间和固定准确性在第2组表现更优,具有统计学意义。张口度变化无统计学差异。未发现任何患者下颌运动范围受限和咬合紊乱。随访期间未发现种植体相关并发症。
三维模型制作可作为一种有价值的辅助手段,以最少的手术时间、提高患者依从性和固定的放射学准确性来改善临床效果。