个性化3D打印模板在髁突骨软骨瘤治疗中的临床应用
Clinical Application of Individualized 3D-Printed Templates in the Treatment of Condylar Osteochondroma.
作者信息
Ma Wen, Niu Shiwei, Wang Lidong, Peng Canbang, Fu Shuai, Zhang Changbin, Cui Qingying, Wang Sihang, Li Ming, Xu Yanhua
机构信息
Department of Oral and Maxillofacial Surgery, Kunming Medical University Affiliated Stomatological Hospital, Yunnan Key Laboratory of Stomatology, Kunming 650106, China.
Yunnan Key Laboratory of Stem Cell and Regenerative Medicine, Science and Technology Achievement Incubation Center, Kunming Medical University, Kunming 650500, China.
出版信息
Healthcare (Basel). 2022 Oct 29;10(11):2163. doi: 10.3390/healthcare10112163.
BACKGROUND
Osteochondroma (OC) is one of the most common benign tumors of the long bones, but it rarely occurs in the maxillofacial skeleton. However, mandibular condylar OC often leads to severe facial deformity in affected patients, including facial asymmetry, deviation of the chin, and malocclusion. This study aimed to explore the clinical application of individualized 3D-printed templates to accurately and effectively treat condylar OC.
METHODS
A total of 8 patients with mandibular condylar OC were treated from July 2015 to August 2021. The enrolled patients (5 women and 3 men) had a median age of 27 years (range: 21-32 years). All patients exhibited symptoms of facial asymmetry and occlusal disorders preoperatively. The digital software used to virtually design the process consisted of three-dimensional reconstruction, 3D-cephalometry analysis, virtual surgery, individualized templates, and postoperative facial soft-tissue prediction. A set of 3D-printed templates (DOS and DOT) were used in all cases to stabilize the occlusion and guide the osteotomy. Then, pre- and post-operative complications, mouth opening, clinical signs, and the accuracy of the CT imaging analysis were all evaluated. All the measurement data were presented as means ± SD; Bonferroni and Tamhane T2 multiple comparison tests were used to examine the differences between the groups.
RESULTS
All patients healed uneventfully. None of the patients exhibited facial nerve injury at follow-up. In comparing the condylar segments with T0p and T1, the average deviation of the condylar segments was 0.5796 mm, indicating that the post-operative reconstructed condyles showed a high degree of similarity to the reconstruction results of the virtual surgical plan.
CONCLUSIONS
Individualized 3D-printed templates simplified surgical procedures and improved surgical accuracy, proving to be an effective method for the treatment of patients with slight asymmetric deformities secondary to condylar OC.
背景
骨软骨瘤（OC）是长骨最常见的良性肿瘤之一，但很少发生于颌面骨骼。然而，下颌髁突骨软骨瘤常导致患侧患者出现严重的面部畸形，包括面部不对称、颏部偏斜和错牙合畸形。本研究旨在探讨个体化3D打印模板在准确、有效治疗髁突骨软骨瘤中的临床应用。
方法
2015年7月至2021年8月共治疗8例下颌髁突骨软骨瘤患者。纳入患者（5例女性，3例男性）的中位年龄为27岁（范围：21 - 32岁）。所有患者术前均表现出面部不对称和咬合紊乱症状。用于虚拟设计过程的数字软件包括三维重建、3D头影测量分析、虚拟手术、个体化模板和术后面部软组织预测。所有病例均使用一组3D打印模板（DOS和DOT）来稳定咬合并引导截骨术。然后，评估术前和术后并发症、开口度、临床体征以及CT成像分析的准确性。所有测量数据均以均值±标准差表示；采用Bonferroni和Tamhane T2多重比较检验来检验组间差异。
结果
所有患者均顺利愈合。随访期间所有患者均未出现面神经损伤。将髁突节段与T0p和T1进行比较时，髁突节段的平均偏差为0.5796 mm，表明术后重建的髁突与虚拟手术计划的重建结果高度相似。
结论
个体化3D打印模板简化了手术操作并提高了手术准确性，被证明是治疗继发于髁突骨软骨瘤的轻度不对称畸形患者的有效方法。
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