Wei X, Zheng J, Bu L, Luo Y, Qiu Y, Yang C
Department of Oral Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, and National Clinical Research Center of Stomatology, Shanghai, China.
Department of Oral Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, and National Clinical Research Center of Stomatology, Shanghai, China.
Int J Oral Maxillofac Surg. 2023 Oct;52(10):1057-1063. doi: 10.1016/j.ijom.2023.03.003. Epub 2023 Mar 27.
The aim of this study was to compare single- and double-layer digital template-assisted genioplasty for the correction of jaw deformity resulting from temporomandibular joint ankylosis (TMJA). Thirteen patients with jaw deformity resulting from TMJA who underwent lateral arthroplasty, costochondral graft, or total joint replacement combined with single- or double-layer digital template-assisted genioplasty were included. Computed tomography data were obtained for the preoperative design. Digital templates were designed and manufactured using three-dimensional printing to assist with the chin osteotomy and repositioning in single- or double-layer genioplasty. Of the 13 patients included, seven underwent single-layer genioplasty and six underwent double-layer genioplasty. The digital templates precisely reflected the osteotomy planes and repositioning of the chin segments intraoperatively. The radiographic evaluation showed that the patients who underwent double-layer genioplasty exhibited more chin advancement (11.95 ± 0.92 mm vs 7.50 ± 0.89 mm; P < 0.001) with a slightly larger mean surface error (1.19 ± 0.14 mm vs 0.75 ± 0.15 mm; P < 0.001) than those who underwent single-layer genioplasty. This indicates that double-layer genioplasty better promoted chin advancement and improved the facial shape, but was accompanied by more surgical error compared with the preoperative design. Furthermore, hardly any nerve damage was observed. Digital templates are useful for assisting in surgical procedures.
本研究旨在比较单层和双层数字模板辅助颏成形术矫正颞下颌关节强直（TMJA）所致颌骨畸形的效果。纳入13例因TMJA导致颌骨畸形并接受了外侧关节成形术、肋软骨移植或全关节置换联合单层或双层数字模板辅助颏成形术的患者。术前通过计算机断层扫描获取数据，利用三维打印设计并制作数字模板，以辅助单层或双层颏成形术中的颏部截骨和复位。13例患者中，7例行单层颏成形术，6例行双层颏成形术。数字模板在术中精确反映了截骨平面和颏部节段的复位情况。影像学评估显示，与单层颏成形术患者相比，双层颏成形术患者颏部前移更多（11.95±0.92 mm比7.50±0.89 mm；P<0.001），平均表面误差略大（1.19±0.14 mm比0.75±0.15 mm；P<0.001）。这表明双层颏成形术能更好地促进颏部前移并改善面部外形，但与术前设计相比手术误差更多。此外，几乎未观察到神经损伤。数字模板有助于辅助手术操作。
