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计算机辅助设计/计算机辅助制造热成型夹板系统在髁突骨折闭合复位中的应用

The Use of a CAD/CAM Thermoformed Splints System in Closed Reduction of Condylar Fractures.

作者信息

Grippaudo Cristina, Lo Giudice Antonino, Saponaro Gianmarco, Todaro Mattia, Moro Alessandro, D'Addona Antonio

机构信息

Dipartimento di Neuroscienze, Organi di Senso e Torace, UOC di Chirurgia Odontostomatologica e Implantologia, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Rome, Italy.

Odontoiatria e Protesi Dentaria, Dipartimento Universitario Testa Collo ed Organi di Senso, Università Cattolica del Sacro Cuore, 00168 Rome, Italy.

出版信息

Bioengineering (Basel). 2023 Aug 29;10(9):1023. doi: 10.3390/bioengineering10091023.

Abstract

(1) Background: Mandibular fractures are very common. Common indications of closed treatment for mandibular fractures are non-displaced or minimally displaced simple fractures in adult compliant patients with good dentition, the absence of occlusal disruption, and fractures in growing children. In closed treatment, the mandible is maintained in centric occlusion with a maxillomandibular fixation (MMF) with orthodontic elastics. Many methods of MMF have been described, often using orthodontic appliances. In recent years, CAD-CAM technology has improved many procedures used in maxillofacial surgery and orthodontics. The device we present is manufactured following a digital workflow, and was designed specifically for MMF. (2) Materials: Two patients with mandibular fractures were treated with an MMF method whose procedure comprised scanning of the dental arches, followed by construction of thermoformed splints on which buttons for the elastics and retention holes are made. The splints were fixed on the dental arches with composite resin at the level of the holes, and were kept in place for the period of healing of the fracture, with the intermaxillary elastics hooked to the buttons. (3) Results: The application time of the splints was very quick. The splints remained stable for the necessary time, without causing particular discomfort to the patients. (4) Conclusions: From our experience, this technique has proved to be reliable and reproducible and could represent a valid tool in the closed treatment of mandibular fractures.

摘要

(1) 背景:下颌骨骨折非常常见。下颌骨骨折闭合治疗的常见适应证为成年依从性好、牙列良好、无咬合紊乱的非移位或轻微移位的简单骨折,以及儿童生长发育期的骨折。在闭合治疗中,通过正畸弹力橡皮圈进行颌间固定(MMF),使下颌骨保持在正中咬合位。已经描述了许多MMF方法,通常使用正畸矫治器。近年来,计算机辅助设计与制造(CAD-CAM)技术改进了颌面外科和正畸学中使用的许多程序。我们展示的装置是按照数字工作流程制造的,并且是专门为MMF设计的。(2) 材料:两名下颌骨骨折患者采用一种MMF方法进行治疗,该方法包括扫描牙弓,随后制作热成型夹板,在夹板上制作用于弹力橡皮圈的纽扣和固位孔。夹板在孔的位置用复合树脂固定在牙弓上,并在骨折愈合期间保持在位,颌间弹力橡皮圈钩挂在纽扣上。(3) 结果:夹板的应用时间非常短。夹板在必要的时间内保持稳定,未给患者造成特别不适。(4) 结论:根据我们的经验,该技术已被证明是可靠且可重复的,并且可能是下颌骨骨折闭合治疗中的一种有效工具。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8d2a/10525750/76468f32563d/bioengineering-10-01023-g001.jpg

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