Zhao Ruilin, Fu Xi, Qiao Jia, He Yu, Xu Shixing, Chen Ying, Yu Bing, Liu Jianfeng, Niu Feng
The First Department of Craniomaxillofacial Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100144, P. R. China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2023 Oct 15;37(10):1270-1275. doi: 10.7507/1002-1892.202306022.
To preliminarily verify the effectiveness of self-designed artificial condyle-mandibular distraction (AC-MD) complex in the treatment of Pruzansky type ⅡB and Ⅲ hemifacial microsomia (HFM) through model test.
Five children with Pruzansky type ⅡB and Ⅲ HFM who were treated with mandibular distraction osteogenesis (MDO) between December 2016 and December 2021 were selected as the subjects. There were 3 boys and 2 girls wih an average age of 8.4 years (range, 6-10 years). Virtual surgery and model test of AC-MD complex were performed according to preoperative skull CT of children. The model was obtained by three-dimensional (3D) printing according to the children's CT data at a ratio of 1∶1. The occlusal guide plate was designed and 3D printed according to the children's toothpaste model. The results of the model test and the virtual surgery were matched in three dimensions to calculate the error of the residual condyle on the affected side, and the model test was matched with the actual skull CT after MDO to measure and compare the inclination rotation of the mandible, the distance between the condylar of the healthy side and the residual condyle of the affected side, and the lengthening length of the mandible.
The error of residual condyle was (1.07±0.78) mm. The inclination rotation of the mandible, the distance between the condylar of the healthy side and the residual condyle of the affected side, and the lengthening length of the mandible after 3D printing model test were significantly larger than those after MDO ( <0.05).
In the model test, the implantation of AC-MD complex can immediately rotate the mandible to the horizontal position and improve facial symmetry, and the residual condyle segment can be guided close to the articular fossa or the preset pseudoarticular position of the skull base after operation.
通过模型试验初步验证自行设计的人工髁突 - 下颌骨牵张（AC - MD）复合体治疗普鲁赞斯基ⅡB型和Ⅲ型半侧颜面短小畸形（HFM）的有效性。
选取2016年12月至2021年12月期间接受下颌骨牵张成骨术（MDO）治疗的5例普鲁赞斯基ⅡB型和Ⅲ型HFM患儿作为研究对象。其中男3例，女2例，平均年龄8.4岁（范围6 - 10岁）。根据患儿术前头颅CT进行AC - MD复合体的虚拟手术和模型试验。按照患儿CT数据以1∶1比例进行三维（3D）打印获得模型。根据患儿牙列模型设计并3D打印咬合导板。将模型试验结果与虚拟手术在三维上进行匹配，计算患侧残余髁突的误差，并将模型试验与MDO术后实际头颅CT进行匹配，测量并比较下颌骨的倾斜旋转度、健侧髁突与患侧残余髁突之间的距离以及下颌骨的延长长度。
残余髁突误差为（1.07±0.78）mm。3D打印模型试验后下颌骨的倾斜旋转度、健侧髁突与患侧残余髁突之间的距离以及下颌骨的延长长度均显著大于MDO术后（<0.05）。
在模型试验中，植入AC - MD复合体可使下颌骨即刻旋转至水平位并改善面部对称性，术后残余髁突段可被引导靠近关节窝或颅底预设的假关节位置。
