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采用选择性激光熔融法制造的患者特异性钛植入物重建下颌轮廓缺陷。

Reconstruction of Mandibular Contour Defect Using Patient-Specific Titanium Implant Manufactured by Selective Laser Melting Method.

机构信息

Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, South Korea.

出版信息

J Craniofac Surg. 2022 Oct 1;33(7):2055-2058. doi: 10.1097/SCS.0000000000008513. Epub 2022 Feb 23.

Abstract

The purpose of this study was to evaluate the surgical accuracy and postoperative stability of patient-specific titanium implants (PSTIs) manufactured by the selective laser melting method and applied for mandibular contour reconstruction. For 2 patients who showed asymmetry of the mandibular angle after mandibuloplasty, including angle reduction, reconstructive surgeries of the mandibular contour defects were performed using PSTI. Patient-specific titanium implant was three-dimensional designed using a mirror image similar to the shape of the contralateral side, and 3 screw holes were formed, avoiding the inferior alveolar nerve. Patient-specific titanium implant was applied intraorally, and screw fixation was performed via a transbuccal approach. Surgical accuracy and postoperative stability were evaluated by comparing preoperative three-dimensional design with immediate postoperative computed tomography (CT), and immediate postoperative CT with postoperative 6-month CT, respectively. Both patients were satisfied with the surgical results, and no complications were observed. Surgical accuracy was defined as a mean Hausdorff distance <0.4mm, and postoperative stability was defined as a mean Hausdorff distance <0.3mm. Our results suggest that PSTI by the selective laser melting method for augmentation of the mandibular border is useful as an additional cosmetic surgery.

摘要

本研究旨在评估选择性激光熔化法制造的用于下颌轮廓重建的个体化钛植入物(PSTI)的手术准确性和术后稳定性。对于 2 例下颌成形术后下颌角不对称的患者,采用 PSTI 进行下颌轮廓缺损的重建手术。使用与对侧相似的镜像形状进行个体化钛植入物的三维设计,并形成 3 个螺钉孔,以避免下牙槽神经。将个体化钛植入物经口内应用,并通过颊侧入路进行螺钉固定。通过比较术前三维设计与即刻术后计算机断层扫描(CT),以及即刻术后 CT 与术后 6 个月 CT,分别评估手术准确性和术后稳定性。两名患者均对手术结果满意,未观察到并发症。手术准确性定义为平均 Hausdorff 距离<0.4mm,术后稳定性定义为平均 Hausdorff 距离<0.3mm。我们的结果表明,选择性激光熔化法用于下颌缘增强的 PSTI 作为一种附加美容手术是有用的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8298/9518971/4f946399c986/scs-33-2055-g001.jpg

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