Wang Lidong, Ma Wen, Fu Shuai, Zhang Changbin, Cui Qingying, Peng Canbang, Li Ming
Dept. of Oral and Maxillofacial Surgery, Stomatology Hospital of Kunming Medical University, Kunming 650000, China.
Hua Xi Kou Qiang Yi Xue Za Zhi. 2022 Jan 25;40(1):68-74. doi: 10.7518/hxkq.2022.01.010.
This study aimed to investigate the application of digital guide plate based on the drill-hole sharing concept in orthognathic surgery and mandibular reconstruction.
Sixteen patients with maxillofacial deformity requiring orthognathic surgery and 10 patients requiring mandibular reconstruction were selected as the research objects. Patients with maxillofacial deformity were scanned by computed tomography (CT), gypsum mold of the maxilla and mandibular arch were scanned using a laser surface scanner, and the fibula or iliac bone of the patients who needed mandibular reconstruction were scanned by CT to create a 3D model. The osteotomy and repositioning guides based on the drill-hole sharing concept were manufactured by digital technology. The guide plate was used to guide osteotomy and reposition the bone segment. Postoperative CT scan was performed. The displacement error of the bone segment was compared between the preoperative virtual surgery and the actual surgery to evaluate the accuracy of the guide plate, by measuring the distance between the landmarks and three reference planes and the distance between the two landmarks.
The wounds healed well in all patients, and no serious complications were observed. The maximum mean values of LeFort Ⅰ osteotomy, genioplasty, fibular reconstruction, and iliac reconstruction were 0.84, 0.64, 1.27, and 1.18 mm, respectively; these values were acceptable by clinical standards.
The digital guide plate based on the drill-hole sharing concept has high accuracy and clinical application value in orthognathic surgery and mandibular reconstruction.
本研究旨在探讨基于钻孔共享概念的数字化导板在正颌外科手术及下颌骨重建中的应用。
选取16例需要正颌外科手术的颌面部畸形患者及10例需要下颌骨重建的患者作为研究对象。对颌面部畸形患者进行计算机断层扫描（CT），用上颌和下颌牙弓石膏模型通过激光表面扫描仪进行扫描，对需要下颌骨重建的患者的腓骨或髂骨进行CT扫描，以创建三维模型。基于钻孔共享概念制造截骨和重新定位导板。使用导板引导截骨并重新定位骨段。术后进行CT扫描。通过测量标志点与三个参考平面之间的距离以及两个标志点之间的距离，比较术前虚拟手术与实际手术中骨段的位移误差，以评估导板的准确性。
所有患者伤口愈合良好，未观察到严重并发症。LeFortⅠ型截骨、颏成形术、腓骨重建和髂骨重建的最大平均值分别为0.84、0.64、1.27和1.18 mm；这些值符合临床标准。
基于钻孔共享概念的数字化导板在正颌外科手术及下颌骨重建中具有较高的准确性和临床应用价值。
