State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Chengdu, China.
J Craniofac Surg. 2022;33(5):1488-1492. doi: 10.1097/SCS.0000000000008394. Epub 2021 Dec 6.
To investigate current Computer-Aided Design and Computer-Aided Manufacturing (CAD/CAM) technologies applied in the treatment of dentofacial deformities secondary to condylar osteochondroma and introduce a modified method with additional pre-bent titanium miniplates to improve the accuracy of operation.
Literature review about the application of CAD/CAM in the treatment of condylar osteochondroma and secondary dentofacial deformities was conducted. And 8 patients with condylar osteochondroma and secondary dentofacial deformities were treated by the CAD/CAM cutting and drilling surgical guides as well as pre-bent titanium miniplates. Pre- and post-operative 3D-cephalometric measurement were recorded and the difference between virtual simulation and postoperative modeling images was measured. Follow-up and radiographic examinations were performed.
A total of 17 studies (including 216 patients) about the application of CAD/CAM in the treatment of dentofacial deformities secondary to condylar osteochondroma have been reported since 2010, including the 8 present patients. In our study, all patients were satisfied with the surgical outcome, without obvious relapse or evidence of temporomandibular joint disorder or other complications during follow-up; all patients avoided condylar reconstruction and sagittal split of ramus osteotomy on the ipsilateral mandible side. Comparison between simulated plans and actual postoperative outcomes showed surgical simulation plan was accurately transferred to the actual surgery.
The application of CAD/CAM cutting and drilling guides as well as pre-bent titanium plates could achieve more accurate and favorable outcomes, improving the clinical planning and surgical execution for patients with condylar osteochondroma and secondary dentofacial deformities.
探讨目前应用于髁突软骨瘤继发牙颌面畸形的计算机辅助设计和计算机辅助制造（CAD/CAM）技术，并介绍一种改良方法，即使用额外预弯钛小板以提高手术精度。
对 CAD/CAM 在髁突软骨瘤及继发牙颌面畸形治疗中的应用进行文献回顾。对 8 例髁突软骨瘤继发牙颌面畸形患者采用 CAD/CAM 切割和钻孔手术导板以及预弯钛小板进行治疗。记录术前和术后三维头颅测量数据，并测量虚拟模拟与术后模型图像之间的差异。进行随访和影像学检查。
自 2010 年以来，共报道了 17 项关于 CAD/CAM 在髁突软骨瘤继发牙颌面畸形治疗中应用的研究（包括 216 例患者），其中包括本研究中的 8 例患者。本研究中，所有患者均对手术结果满意，随访期间无明显复发，无颞下颌关节紊乱或其他并发症的证据；所有患者均避免了同侧下颌髁突重建和下颌支矢状劈开。模拟计划与实际术后结果的比较表明，手术模拟计划准确地转化为实际手术。
CAD/CAM 切割和钻孔导板以及预弯钛板的应用可以实现更准确、更有利的结果，改善髁突软骨瘤及继发牙颌面畸形患者的临床规划和手术执行。
