CAJ | 학술논문

目的探讨计算机辅助设计与制作(CAD-CAM)在下颌骨缺损赝复体设计、制作及临床中的应用.方法下颌骨升支及下颌角肿瘤患者6例术前行螺旋CT扫描,利用CAD-CAM在三维虚拟模型上进行模型外科设计,三维虚拟模型上调整下颌骨赝复体的位置、大小和形状.在达到最佳设计要求后,通过与电脑相连的精雕机直接将医用钛合金切削成钛赝复体,设计并制成与患者下颌骨缺损区正常外形相同的个体化钛赝复体,术中根据术前设计切除下颌骨病变区骨组织,植入个体化钛赝复体.结果 6例术中显示下颌骨钛赝复体与下颌骨缺损区吻合程度一致.术后随访9～38个月.X线片显示钛赝复体与下颌骨贴合良好,重建的下颌骨形态对称良好.术后患者面部外形恢复正常,咬合关系及张口度恢复良好.结论 CAD-CAM为下颌骨病变的术前手术设计、钛修复赝复体的个体化设计制作提供了精确的模拟及快速制作过程,简化了以往钛金属赝复体需要翻模铸造或快速原型法(rapid prototyping,RP)实体模型的制作流程,提高了手术的精确性,术后患者功能恢复良好.对于下颌骨升支及角部的缺损,钛金属赝复体不失为一种良好的修复重建方法.
목적 탐토계산궤보조설계여제작(CAD-CAM)재하합골결손안복체설계、제작급림상중적응용.방법 하합골승지급하합각종류환자6례술전행라선CT소묘,이용CAD-CAM재삼유허의모형상진행모형외과설계,삼유허의모형상조정하합골안복체적위치、대소화형상.재체도최가설계요구후,통과여전뇌상련적정조궤직접장의용태합금절삭성태안복체,설계병제성여환자하합골결손구정상외형상동적개체화태안복체,술중근거술전설계절제하합골병변구골조직,식입개체화태안복체.결과 6례술중현시하합골태안복체여하합골결손구문합정도일치.술후수방9～38개월.X선편현시태안복체여하합골첩합량호,중건적하합골형태대칭량호.술후환자면부외형회복정상,교합관계급장구도회복량호.결론 CAD-CAM위하합골병변적술전수술설계、태수복안복체적개체화설계제작제공료정학적모의급쾌속제작과정,간화료이왕태금속안복체수요번모주조혹쾌속원형법(rapid prototyping,RP)실체모형적제작류정,제고료수술적정학성,술후환자공능회복량호.대우하합골승지급각부적결손,태금속안복체불실위일충량호적수복중건방법.
Objective To investigate the application of computer aided design-computer aided manufacture(CAD-CAM)technique in the reconstruction of mandible defect with individual titanium prosthesis. Methods Six patients with large mandibular ramus and angle tumor were spiral CT scanned preoperatively, and the CAD-CAM was used to design and make individual titanium prosthesis for reconstructing the mandibular defects after resection of the tumor. The prosthesis were assembled during operation. Postoperative follow-up period was 9-38 months.Results The design and manufacture of titanium prosthesis by use of CAD-CAM technique was convenient and the prosthesis fitted the defects very well.The outline of the face,the occlusion and function were restored. After 9-38 months of follow-up, the mandibular symmetry was good.Conclusions The application of CAD-CAM provided accurate simulation and fast manufacturing process for the titanium prosthesis in the repair of mandibular defect.