Department of Stomatology, The First Affiliated Hospital of Fujian Medical University, Tai-Jiang District, No.20 Cha-Ting-Zhong Road, Fuzhou, 350005, China.
Department of Stomatology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350212, China.
BMC Oral Health. 2024 Sep 3;24(1):1032. doi: 10.1186/s12903-024-04828-z.
This study evaluates a three-dimensional (3D) visualisation design combined with customized surgical guides to assist anterior maxillary segmental distraction osteogenesis (AMSDO) in correcting maxillary hypoplasia in adolescents with cleft lip and palate (CLP), focusing on treatment outcomes, satisfaction and the validity of 3D planning.
This retrospective cohort study was conducted at a single hospital in China. Between January 2020 and December 2023, 12 adolescents with CLP with maxillary hypoplasia were included. An advanced 3D simulation was used to convey the treatment strategy to the patients and their families. A customized surgical guide and distraction osteogenesis device were designed. Cephalometric analysis evaluated AMSDO changes and long-term stability. Patient satisfaction was assessed. The Chinese version of the Child Oral Health Impact Profile was used to evaluate the children's oral health-related quality of life before and after treatment. The postoperative outcomes were compared with the planned outcomes by superimposing the actual postoperative data onto the simulated soft tissue models and calculating the linear and angular differences between them.
One patient experienced postoperative gingivitis, yielding an 8.33% complication rate. Most patients (83.33%) were highly satisfied with the target position, with the rest content. Cephalometric analysis showed significant improvements in various indices post-traction. Quality-of-life scores significantly improved post-treatment. The discrepancies in facial soft tissue between the simulated and actual results were within clinically satisfactory ranges.
Digitally designed surgical guides effectively treat maxillary hypoplasia in adolescents with CLP, ensuring stability, reducing complications, reducing dependency on operator experience, and enhancing satisfaction and health outcomes. Although the simulated results were clinically acceptable, it is important to inform patients of potential variations in the predicted soft tissue.
本研究评估了一种三维（3D）可视化设计与定制手术导板相结合，以辅助前上颌节段性牵引成骨术（AMSDO）治疗唇腭裂（CLP）青少年的上颌发育不全，重点关注治疗效果、满意度和 3D 规划的有效性。
这是一项在中国一家医院进行的回顾性队列研究。2020 年 1 月至 2023 年 12 月，纳入 12 例上颌发育不全的 CLP 青少年患者。先进的 3D 模拟用于向患者及其家属传达治疗策略。设计定制手术导板和牵引成骨装置。头影测量分析评估 AMSDO 变化和长期稳定性。评估患者满意度。使用中文版儿童口腔健康影响简表评估治疗前后儿童口腔健康相关生活质量。将实际术后数据叠加到模拟软组织模型上，并计算它们之间的线性和角度差异，以比较术后结果与计划结果。
1 例患者术后出现牙龈炎，并发症发生率为 8.33%。大多数患者（83.33%）对目标位置高度满意，其余患者也满意。牵引后各项指标均有显著改善。治疗后生活质量评分显著提高。模拟和实际结果之间的面部软组织差异在临床可接受范围内。
数字化设计的手术导板可有效治疗 CLP 青少年的上颌发育不全，确保稳定性，减少并发症，降低对术者经验的依赖性，提高满意度和健康结果。虽然模拟结果具有临床可接受性，但告知患者预测软组织可能存在的变化很重要。
