数字化导板在正颌外科的应用进展

doi:10.3969/j.issn.1005-4979.2018.05.011

摘要/Abstract

摘要： 正颌外科是通过外科手术与口腔正畸联合治疗，由于先天的生长发育异常或者后天的外伤等引起的单纯正畸不能解决的牙颌面畸形。颌面部血供丰富，解剖结构复杂，正颌手术术中常发生出血多、神经血管损伤、牙根损伤等各种并发症。为了降低这些并发症的发生率，以及使术后颌骨达到精确稳定的理想位置，正颌手术需使用各类导板[1]来辅助手术。传统导板制作流程复杂、误差大、耗时多。近年来，随着计算机辅助外科技术（CAS）的发展，运用数字化技术可以打印出不同的导板。数字化导板因拥有高精确性，能显著缩短手术时间，具有传统导板无法比拟的优点，目前被广泛应用到正颌外科手术中。本文就近年来数字化导板在正颌外科中的应用作一综述。

关键词: 正颌外科, 计算机辅助外科, 数字化导板

Abstract: Orthognathic surgery is a treatment procedure with a combination of surgical operation and orthodontic principles in the reconstruction of congenital or acquired abnormalities in the dentomaxillofacial region. The maxillofacial structure is very rich in blood supply with complex anatomical variations. Operation hemorrhage, neurovascular injury, injury to the root apices of the tooth and other complications often occur during orthognathic surgery .In order to reduce the incidence of these complications and to achieve postoperative accurate and stable ideal jaw position, orthognathic surgery procedure needs a variety of guides (surgical template) to assist . However, the production process of traditional guide plate is complex and there are high chances of error. With the development of Computer Aided Surgery (CAS) in recent years, more and more guide plates can be printed by digital technology. The digital guide plate has been applied to orthognathic surgery more frequently due to the advantages of high accuracy and short operation time than those traditional guides. In this paper, the advances of application of digital template in orthognathic surgery in recent years is reviewed.

Key words: orthognathic surgery, computer assisted surgery, digital template

中图分类号:

R782.4

田玲, 周诺, 李鸿艺. 数字化导板在正颌外科的应用进展[J]. 《口腔颌面外科杂志》, doi: 10.3969/j.issn.1005-4979.2018.05.011.

TIAN Ling, ZHOU Nuo, LI Hong-yi. Recent Advances of Digital Template in Orthognathic Surgery[J]. 《Journal of Oral and Maxillofacial Surgery》, doi: 10.3969/j.issn.1005-4979.2018.05.011.

https://journal06.magtech.org.cn/Jweb_joms/CN/Y2018/V28/I5/293

参考文献

[1] 段银钟, 孙应明, 顾晓明, 等. 各种咬合导板在正畸正颌中的应用[J]. 口腔颌面外科杂志, 2001, 11(S1): 24-25.

[2] 吉利, 龙星, 贺红. 咬合板治疗颞下颌关节盘移位的疗效评价[J]. 口腔医学研究, 2008, 24(1): 78-81.

[3] 金家生. 数字化种植导板在口腔种植中的临床观察[D]. 大连: 大连医科大学, 2017.

[4] 朴英顺. 下颌联冠斜面导板矫治前牙反合临床疗效观察[J]. 中国医学工程, 2011, 19(10): 90, 93.

[5] 罗颂椒, 陈扬熙, 王大章, 等. 导板在正颌外科手术中的作用[J]. 华西口腔医学杂志, 1987, 5(1): 49-50.

[6] 宋大立. 模型外科技术在正颌外科中的应用[J]. 实用口腔医学杂志, 2016, 32(5): 741-744.

[7] Olszewski R, Reychler H. Limitations of orthognathic model surgery: theoretical and practical implications[J]. Rev Stomatol Chir Maxillofac, 2004, 105(3): 165-169.

[8] Murphy SV, Atala A. 3D bioprinting of tissues and organs[J]. Nat Biotechnol, 2014, 32(8): 773-785.

[9] McAllister P, Watson M, Burke E. A cost-effective, in-house, positioning and cutting guide system for orthognathic surgery[J]. J Maxillofac Oral Surg, 2018, 17(1): 112-114.

[10] 林艳萍, 陈晓军, 张诗雷, 等. 基于三维模拟的定位板快速原型制作法[J]. 生物医学工程学杂志, 2006, 23(2): 424-427.

[11] 张超. 数字化截骨导板在下颌角截骨术中的应用研究[D].北京：北京协和医学院,2014.

[12] 代杰文, 王璧霞, 魏弘朴, 等. 数字化正颌外科流程及临床效果回顾性分析[J]. 上海交通大学学报(医学版), 2016, 36(9): 1333-1340.

[13] 李欣欣, 华泽权, 王燕, 等. CT三维重建下探讨BSSRO术舌侧水平截骨线与骨劈开效果的关系[J]. 临床口腔医学杂志, 2012, 28(1): 20-22.

[14] 屈振宇, 王茜, 丰鑫, 等. 3D打印技术在双侧下颌升支矢状劈开截骨术中的应用[J]. 华西口腔医学杂志, 2015, 33(5): 504-508.

[15] 于天平. 下颌升支矢状劈开截骨术下颌骨裂开方式的观测研究[D]. 天津: 天津医科大学, 2014.

[17] 孔旭, 金元, 梁久龙, 等. 3D打印技术在下颌角整形手术中的应用[J]. 中国美容整形外科杂志, 2017, 28(8): 461-463.

[18] 孙昊, 王旭东, 沈国芳, 等. 三维软硬组织模拟与虚拟截骨导板在牵张成骨中的应用:附1例报告[J]. 中国口腔颌面外科杂志, 2009, 7(6): 505-508.

[19] 胡文煦, 王涛, 高翔, 等. 下颌骨不同角度牵张成骨术矫正颜面不对称的临床研究[J]. 第三军医大学学报, 2009, 31(16): 1602-1604.

[20] 雷博程, 高小波, 冯敏, 等. 面部不对称畸形矫治中计算机辅助设计结合三维打印手术导板的应用[J]. 全科口腔医学电子杂志, 2016, 3(14): 72, 74.

[21] Hsu SS, Gateno J, Bell RB, et al. Accuracy of a computer-aided surgical simulation protocol for orthognathic surgery: a prospective multicenter study[J]. J Oral Maxillofac Surg, 2013, 71(1): 128-142.

[22] 沈映勋, 张策, 曹德君. 颏成形术发展及现况[J]. 组织工程与重建外科杂志, 2015, 11(2): 116-119.

[23] 陈莹, 牛峰, 归来, 等. 三维数字化在颏部水平截骨术中的应用[J]. 中国美容整形外科杂志, 2017, 28(1): 16-18.

[24] Qiao J, Fu X, Gui L, et al. Computer image-guided template for horizontal advancement genioplasty[J]. J Craniofac Surg, 2016, 27(8): 2004-2008.

[25] 陈卓辉, 曾融生, 杨小平, 等. 双板在双颌正颌外科中的应用[J]. 广东牙病防治, 1999, 7(4): 274-275.

[26] Kwon TG, Mori Y, Minami K, et al. Reproducibility of maxillary positioning in le fort I osteotomy: a 3-dimensional evaluation[J]. J Oral Maxillofac Surg, 2002, 60(3): 287-293.

[27] Kwon TG, Choi JW, Kyung HM, et al. Accuracy of maxillary repositioning in two-jaw surgery with conventional articulator model surgery versus virtual model surgery[J]. Int J Oral Maxillofac Surg, 2014, 43(6): 732-738.

[28] Hatamleh M, Turner C, Bhamrah G, et al. Improved virtual planning for bimaxillary orthognathic surgery[J]. J Craniofac Surg, 2016, 27(6): e568-e573.

[29] Li B, Zhang L, Sun H, et al. A novel method of computer aided orthognathic surgery using individual CAD/CAM templates: a combination of osteotomy and repositioning guides[J]. Br J Oral Maxillofac Surg, 2013, 51(8): e239-e244.

[30] Li B, Zhang L, Sun H, et al. A new method of surgical navigation for orthognathic surgery: optical tracking guided free-hand repositioning of the maxillomandibular complex[J]. J Craniofac Surg, 2014, 25(2): 406-411.

[31] 金家生. 数字化种植导板在口腔种植中的临床观察[D]. 大连: 大连医科大学, 2017.

[32] 王育新, 王志勇, 卢明星, 等. 系列数字化导板在腓骨肌皮瓣修复下颌骨缺损中的初步应用[J]. 口腔医学研究, 2017, 33(5): 542-545.

选择文件类型/文献管理软件名称

选择包含的内容