Medical Faculty, Johannes Kepler University Linz, Altenberger Strasse 69, 4040, Linz, Austria.
NumBioLab, Ludwig-Maximilians University of Munich, Munich, Germany.
Eur J Med Res. 2022 Jul 2;27(1):104. doi: 10.1186/s40001-022-00726-8.
Bone biopsies are often necessary to make a diagnosis in the case of irregular bone structures of the jaw. A 3D-printed surgical guide may be a helpful tool for enhancing the accuracy of the biopsy and for ensuring that the tissue of interest is precisely removed for examination. This study was conducted to compare the accuracy of biopsies performed with 3D-printed surgical guides to that of free-handed biopsies.
Computed tomography scans were performed on patients with bony lesions of the lower jaw. Surgical guides were planned via computer-aided design and manufactured by a 3D-printer. Biopsies were performed with the surgical guides. Bone models of the lower jaw with geometries identical to the patients' lower jaws were produced using a 3D-printer. The jaw models were fitted into a phantom head model and free-handed biopsies were taken as controls. The accuracy of the biopsies was evaluated by comparing the parameters for the axis, angle and depth of the biopsies to the planned parameters.
Eight patients were included. The mean deviation between the biopsy axes was significantly lower in guided procedures than in free-handed biopsies (1.4 mm ± 0.9 mm; 3.6 mm ± 1.0 mm; p = 0.0005). The mean biopsy angle deviation was also significantly lower in guided biopsies than in free-handed biopsies (6.8° ± 4.0; 15.4° ± 3.6; p = 0.0005). The biopsy depth showed no significant difference between the guided and the free-handed biopsies.
Computer-guided biopsies allow significantly higher accuracy than free-handed procedures.
在颌骨不规则骨结构的情况下，通常需要进行骨活检以做出诊断。3D 打印的手术导板可能是提高活检准确性并确保准确切除感兴趣组织进行检查的有用工具。本研究旨在比较使用 3D 打印手术导板进行的活检与徒手活检的准确性。
对下颌骨有骨病变的患者进行计算机断层扫描。通过计算机辅助设计规划手术导板，并通过 3D 打印机制造。使用手术导板进行活检。使用 3D 打印机制作与患者下颌几何形状完全相同的下颌骨模型。将下颌骨模型安装在幻影头模型中，并作为对照进行徒手活检。通过比较活检的轴、角度和深度的参数与计划参数来评估活检的准确性。
共纳入 8 例患者。与徒手活检相比，引导活检的活检轴偏差平均值明显更低（1.4 ± 0.9mm；3.6 ± 1.0mm；p = 0.0005）。引导活检的活检角度偏差平均值也明显低于徒手活检（6.8°±4.0°；15.4°±3.6°；p = 0.0005）。活检深度在引导和徒手活检之间无显著差异。
计算机引导的活检比徒手操作具有更高的准确性。
