基于CBCT三维可视化技术与3D打印技术在复杂阻生牙拔除术中的临床研究

doi:10.3969/j.issn.1005-4979.2021.05.005

《口腔颌面外科杂志》 ›› 2021, Vol. 31 ›› Issue (5): 292-297. doi: 10.3969/j.issn.1005-4979.2021.05.005

基于CBCT三维可视化技术与3D打印技术在复杂阻生牙拔除术中的临床研究

吴亮颖¹(), 屠军波², 刘坚³, 张卫平⁴()

¹ 兰州市口腔医院影像放射科，甘肃兰州 730000
² 西安交通大学口腔医院,陕西省牙颌疾病临床医学研究中心，陕西西安 710004
³ 兰州市口腔医院颌面外科，甘肃兰州 730000
⁴ 兰州市首席专家工作室，甘肃兰州 730000

收稿日期:2020-09-23 修回日期:2020-11-01 出版日期:2024-03-21 发布日期:2021-12-30
通讯作者: 张卫平
作者简介:
吴亮颖（1984—），女，甘肃兰州人，副主任医师，硕士研究生. E-mail: 328904799@qq.com
基金资助:
陕西省牙颌疾病临床医学研究中心开放课题(2019YHJB07); 兰州市城关区科技发展计划项目(2016CGKJ106)

Clinical research of extraction of complex impacted teeth based on CBCT 3D visualization technology and 3D printing technology

WU Liangying¹(), TU Junbo², LIU Jian³, ZHANG Weiping⁴()

¹ Department of Radiology, Lanzhou Municipal Stomatological Hospital, Lanzhou 730000, Gansu Province
² Hospital of Stomatology, Xi′an Jiaotong University, Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, Xi′an 710004
³ Department of Maxillofacial Surgery, Lanzhou Municipal Stomatological Hospital, Lanzhou 730000, Gansu Province
⁴ Lanzhou Municipal First Expert Studio, Lanzhou 730000, Gansu Province, China

Received:2020-09-23 Revised:2020-11-01 Online:2024-03-21 Published:2021-12-30
Contact: ZHANG Weiping

摘要/Abstract

摘要：

目的： 前瞻性研究并分析基于锥形束CT（CBCT）三维可视化与3D打印技术在复杂阻生牙拔除术中的应用价值。方法： 选取2020年4月—2020年8月于我院就诊的60例复杂阻生牙拔除术患者作为研究对象，采用随机信封法将患者分为2组（A组和B组），每组各30例。对A组患者CBCT影像数据进行三维可视化处理，通过三维可视化模型进行术前评估和制定手术计划，B组患者应用三维可视化数据打印3D实体模型进行术前评估和手术方案制订，比较分析2组治疗疗效和随访结果。结果： B组手术时长小于A组（P<0.05），治疗优良率高于A组（P<0.05），并发症发生率低于A组（P<0.05），患者满意度优于A组（P<0.05）。结论： 基于CBCT的3D打印技术在复杂阻生牙拔除术中的应用效果较好，可直观展示埋伏阻生牙的空间位置关系，并真实模拟手术过程，为术前评估和手术方案的制订提供帮助，使手术精准、安全、高效，值得推广应用。

关键词: 三维可视化技术, 3D打印技术, 复杂阻生牙

Abstract:

Objective: To prospectively analyze the application value of 3D visualization and 3D printing technology based on CBCT in the extraction of complex impacted teeth. Methods: From April 2020 to August 2020, 60 patients with complicated impacted teeth extraction in our hospital were selected as the research objects and divided into two groups (group A and group B) by random envelope method, with 30 patients in each group. In group A, CBCT image data were processed by 3D visualization, preoperative evaluation and operation plan were carried out by three-dimensional visualization model. As for group B, 3D solid model was used for preoperative evaluation and formulation of surgical plan, and the therapeutic effect and follow-up results of the two groups were compared and analyzed. Results: The operation time of group B was shorter than that of group A (P<0.05); the excellent and good rate of treatment was higher than that of group A (P<0.05); the incidence of complications was lower than that of group A(P<0.05), and patient satisfaction was better than that of group A(P<0.05). Conclusion: The 3D printing technology based on CBCT has a good application effect in the extraction of complex impacted teeth. It can visually display the spatial relationship of impacted teeth, simulate the surgical process in real life, and provide help to make preoperative evaluation and surgical plan formulation, so as to achieve accurate, safe and efficient surgery, and it is worthy of popularization and application.

Key words: 3D visualization technology, 3D printing technology, complex impacted teeth

吴亮颖, 屠军波, 刘坚, 张卫平. 基于CBCT三维可视化技术与3D打印技术在复杂阻生牙拔除术中的临床研究[J]. 《口腔颌面外科杂志》, 2021, 31(5): 292-297.

WU Liangying, TU Junbo, LIU Jian, ZHANG Weiping. Clinical research of extraction of complex impacted teeth based on CBCT 3D visualization technology and 3D printing technology[J]. 《Journal of Oral and Maxillofacial Surgery》, 2021, 31(5): 292-297.

https://journal06.magtech.org.cn/Jweb_joms/CN/Y2021/V31/I5/292

图/表 8

图1 三维可视化侧面观

Figure 1 Three-dimensional visualization lateral view

图2 虚拟重建重要解剖结构

Figure 2 Virtual reconstruction of important anatomical structure

图3 三维可视化阻生牙位置 A. 俯视位；B. 前后位；C. 水平位。

Figure 3 Three-dimensional visualization of impacted teeth position

图4 三维可视化虚拟手术 A. 虚拟分冠、分根；B. 虚拟去除牙冠；C. 虚拟去除远中根。

Figure 4 3D visual virtual surgery

图5 3D打印模型模拟手术 A. 3D打印实体模型；B. 模拟手术操作；C. 模拟去骨；D~F. 模拟分冠。

Figure 5 3D printing model simulating extraction procedures

图6 技术路线图

Figure 6 Technology roadmap

表1 2组患者治疗效果比较[n（%）]

Table 1 Comparison of the treatment effects in the two groups [n（%）]

组别	例数	治疗效果			优良率/%
组别	例数	优	良	差	优良率/%
A组	30	13（43.33）	6（20.00）	11（36.67）	63.33
B组	30	19（63.33）	8（26.67）	3（10.00）	90.00^①
U/χ²			Z=2.037		χ²=20.275
P值			0.042		<0.001

表2 2组患者并发症发生率比较[n（%）]

Table 2 Comparison of the incidence of complications in the two groups [n（%）]

组别	并发症						合计
组别	舌侧骨板骨折	根折、断根	邻牙松动或损伤	软组织肿胀	术后出血	术后感染	合计
A组	1（3.33）	1（3.33）	2（6.67）	5（16.67）	1（3.33）	1（3.33）	11（36.67）
B组	0	0	0	2（6.67）	1（3.33）	0	3（10.00）^①
χ²	1.017	1.017	2.069	1.456	0.351	1.017	7.200
P值	0.313	0.313	0.150	0.228	0.554	0.313	0.007

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基于CBCT三维可视化技术与3D打印技术在复杂阻生牙拔除术中的临床研究

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