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理想的个体化植入物:下颌I类、II类Brown缺损的八步设计清单

The Ideal Patient-Specific Implant: An Eight Step Design Checklist for Mandibular Class I,II Brown Defects.

作者信息

Chowdhury Sanjay Kumar Roy, Padha Karan, Singh Sneha, Yadav Pradeep, Prajapati Ravi

机构信息

AFDC, KG Marg, New Delhi, 110001 India.

New Delhi, India.

出版信息

J Maxillofac Oral Surg. 2025 Jun;24(3):707-715. doi: 10.1007/s12663-025-02502-7. Epub 2025 Mar 13.

Abstract

OBJECTIVES

Patient-specific implants (PSI) are the next frontier in maxillofacial reconstruction, and though autogenous reconstruction of Brown I,II mandibulectomy defects is still the gold standard, the advantages of patient-specific implants, namely being reduced duration of surgery, prediction of failure due to biomechanical accuracy and FEA analysis, make it the prime alternative. However, the lack of standardisation in design leads to complications like wound dehiscence, poor dimensional accuracy and unoptimised biomechanics thus impeding its widespread acceptance among the scientific community.

METHODS

The authors aimed to address this lacunae in literature and answer the question whether PSI's can be designed through a standardised set of protocols? Through this study, the authors present an eight step checklist to be followed for designing of an ideal standardised patient-specific implant in a Brown I,II mandibular defect not involving the condyle which can serve as a go to guide for the operating and designing team.

CONCLUSION

PSI's through an optimised designing and manufacturing process can serve as an exciting new treatment modality and an alternative to the gold standard autogenous reconstruction.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s12663-025-02502-7.

摘要

目的

定制植入物(PSI)是颌面重建的下一个前沿领域,虽然Brown I、II型下颌骨切除术缺损的自体重建仍是金标准,但定制植入物的优势,即缩短手术时间、因生物力学准确性和有限元分析预测失败情况,使其成为主要替代方案。然而,设计缺乏标准化会导致伤口裂开、尺寸精度差和生物力学未优化等并发症,从而阻碍其在科学界的广泛接受。

方法

作者旨在填补文献中的这一空白,并回答是否可以通过一套标准化方案设计定制植入物这一问题?通过本研究,作者提出了一个八步检查表,用于在不涉及髁突的Brown I、II型下颌骨缺损中设计理想的标准化定制植入物,可为手术和设计团队提供指导。

结论

通过优化设计和制造过程,定制植入物可成为一种令人兴奋的新治疗方式,并替代金标准的自体重建。

补充信息

在线版本包含可在10.1007/s12663-025-02502-7获取的补充材料。

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本文引用的文献

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Scope of PSI in Maxillofacial Region: Our Experience.压力敏感成像在颌面部区域的应用范围:我们的经验
J Maxillofac Oral Surg. 2023 Mar;22(Suppl 1):124-132. doi: 10.1007/s12663-022-01832-0. Epub 2022 Dec 14.
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Design and optimization of the fixing plate for customized mandible implants.定制下颌骨植入物固定板的设计与优化
J Craniomaxillofac Surg. 2015 Sep;43(7):1296-302. doi: 10.1016/j.jcms.2015.06.003. Epub 2015 Jun 17.

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