Eufinger H, Wehmöller M, Machtens E
Department of Oral and Maxillofacial Surgery--Regional Plastic Surgery at the University Hospital Knappschafts-Krankenhaus, Ruhr-University, Bochum, Germany.
Br J Oral Maxillofac Surg. 1997 Dec;35(6):413-8. doi: 10.1016/s0266-4356(97)90718-x.
This new technique uses helical computed tomography data and computer-aided design and manufacturing for preoperative fabrication of individual mandibular prostheses together with corresponding resection templates. Coherent 3D geometries for computer-based models are the basis for the construction of prostheses and provide data for a computerized numerical control fabrication. Fixation plates are fabricated with the titanium prostheses. The identical data of these plates are used for the computer-aided design and manufacturing of resection templates, which guide an oscillating saw in a precisely determined resection plane. This plane again is identical with the prostheses' margins for mandibular body replacement. The use of this technique in four patients is reported on: after temporary insertion of the templates for resection and after resection, the prostheses were stabilized with the same screws in the same screw-holes where the templates had been. Resection and reconstruction were thus highly precise, safe and fast and primarily led to excellent aesthetic and functional results. Wound-healing depends on a safe soft-tissue reconstruction over these large prostheses. Coverage with flaps seems obligatory. In spite of the superior technical aspects, the clinical long-term results of this new technique were poor.
这项新技术利用螺旋计算机断层扫描数据以及计算机辅助设计与制造，用于术前制作个性化下颌假体以及相应的切除模板。基于计算机模型的连贯三维几何形状是假体构建的基础，并为计算机数控制造提供数据。固定板与钛制假体一起制作。这些板的相同数据用于计算机辅助设计和制造切除模板，该模板在精确确定的切除平面内引导摆动锯。这个平面又与用于下颌骨体置换的假体边缘相同。本文报告了该技术在4例患者中的应用情况：在临时插入切除模板后以及切除后，假体通过与模板相同的螺钉固定在相同的螺孔中。因此，切除和重建高度精确、安全且快速，并且主要带来了出色的美学和功能效果。伤口愈合取决于在这些大型假体上进行安全的软组织重建。似乎必须用皮瓣覆盖。尽管在技术方面具有优势，但这项新技术的临床长期效果不佳。
