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采用三维打印导板行微创牙槽外科中的硬组织保存与修复。

Hard Tissue Preservation and Recovery in Minimally Invasive Alveolar Surgery Using Three-Dimensional Printing Guide Plate.

机构信息

Department of Oral and Maxillofacial Surgery, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.

出版信息

J Craniofac Surg. 2022;33(5):e476-e481. doi: 10.1097/SCS.0000000000008370. Epub 2021 Nov 12.

Abstract

BACKGROUND

For completely impacted teeth, it is of great significance to locate teeth accurately, preserve hard tissue and recovering the height of alveolar ridge. This can be effectively solved by the digital three-dimensional printing guide technology.

METHODS

Ten patients with completely impacted tooth were selected in this experiment. After cone-beam computed tomography scan, the dicom formal computed tomography data was analyzed for threedimensional reconstruction by mimics 17.0 software. Then determining the surgical plan and making surgical guide plate. Threedimensional printing guide plate assisted piezosurgery was used to remove bone and extract impacted teeth. After that, the removed bone cap was back to the original position. Cone-beam computed tomography was used for each operated patients after 1 week and 6 months.

RESULT

The surgical guide plates can locate teeth accurately and the surgery time was reduced for all patients. A week later, all patients healed well and removed the stitches on time. Cone-beam computed tomography showed that the retention of bone caps was good and there was no displacement. All patients showed a normal parameter of pain. Six months later, cone-beam computed tomography showed good bone formation in the extraction area, which filled with new bones completely. The recovery of bone outline and height of alveolar crest at the surgical site were basically consistent with those before the operation.

CONCLUSIONS

Three-dimensional printing guide plates combining with fenestration and bone-cap restoration can locate impacted teeth accurately, reduce the extraction volume of bone, shorten surgery time, and alleviate complications. This was conducive to preserve and restore hard tissue and had great prospective.

摘要

背景

对于完全埋伏阻生的牙齿,准确地定位牙齿、保护硬组织和恢复牙槽嵴高度具有重要意义。数字化三维打印导板技术可有效地解决这一问题。

方法

本实验选取 10 例完全埋伏阻生牙患者,经锥形束 CT 扫描后,利用 Mimics17.0 软件对 dicom 格式的 CT 数据进行三维重建分析,确定手术方案并制作手术导板。采用三维打印导板辅助超声骨刀去除骨阻力并拔除埋伏牙,然后将取出的骨瓣原位回植。术后第 1 周和第 6 个月对所有患者进行锥形束 CT 检查。

结果

所有患者的手术导板均能准确定位牙齿,且手术时间缩短。术后 1 周,所有患者均愈合良好,按时拆线。锥形束 CT 显示骨帽保留良好,无移位。所有患者疼痛参数均正常。术后 6 个月,锥形束 CT 显示拔牙区有良好的骨形成,新骨完全填充。手术部位牙槽嵴的骨轮廓和高度恢复基本与术前一致。

结论

开窗及骨帽回植联合三维打印导板可准确定位埋伏牙,减少骨的去除量,缩短手术时间,减轻并发症,有利于保护和恢复硬组织,具有广阔的应用前景。

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