CAJ | 학술논문

目的探讨计算机辅助设计(CAD)在定向二次牵引成骨术修复半侧下颌骨缺损中的应用及效果.方法 8例因肿瘤术后致下颌骨缺损患者,采用三维螺旋CT扫描结合CAD,制定手术方案,定制牵引器,Ⅰ期手术牵引下颌骨体部,Ⅱ期手术牵引下颌骨升支部.结果手术过程顺利,创口均Ⅰ期愈合,下颌外形恢复良好,局部成骨较满意,无感染等并发症.下颌骨体部单侧最大牵引幅度为5.5 cm,平均4.9 cm,升支部最大4.5 cm,平均3.6 cm.张口度3～5 cm,健侧咬合良好,均取得了满意的治疗效果.牵引完成8个月后拆除牵引器.结论对肿瘤术后导致半侧下颌骨缺损的患者,通过CAD实现定向二次牵引成骨,效果稳定可靠.为准确诊断、确定治疗方案提供指导,为实现手术导航和下颌骨缺损的精确修复重建提供仿真平台.缺点是整个治疗时间长,需3次手术.
목적 탐토계산궤보조설계(CAD)재정향이차견인성골술수복반측하합골결손중적응용급효과.방법 8례인종류술후치하합골결손환자,채용삼유라선CT소묘결합CAD,제정수술방안,정제견인기,Ⅰ기수술견인하합골체부,Ⅱ기수술견인하합골승지부.결과 수술과정순리,창구균Ⅰ기유합,하합외형회복량호,국부성골교만의,무감염등병발증.하합골체부단측최대견인폭도위5.5 cm,평균4.9 cm,승지부최대4.5 cm,평균3.6 cm.장구도3～5 cm,건측교합량호,균취득료만의적치료효과.견인완성8개월후탁제견인기.결론 대종류술후도치반측하합골결손적환자,통과CAD실현정향이차견인성골,효과은정가고.위준학진단、학정치료방안제공지도,위실현수술도항화하합골결손적정학수복중건제공방진평태.결점시정개치료시간장,수3차수술.
Objective To investigate the feasibility of using computer-aided design (CAD) in double-step distraction osteogenesis in the reconstruction of mandibular segmental defects after tumor resection. Methods Eight cases of unilateral mandibular segmental defects were reconstructed using distraction osteogenesis secondary to oncoiogic surgery, with the help of CT and CAD system. The mandibular body was lengthened first, and then the residual defect of mandibular ramus was restored using a distraction device. Results No incidence of infection or other complications were observed. The maximal amount of the lengthening reached 55 mm in the mandibular body, and 45 mm in the mandibular ramus. The average amount of the lengthening reached 49 nun in the mandibular body, and 36 mm in the mandibular ramus. The aesthetic and functional results of bone lengthening were excellent in all cases. The retractor was removed eight months postoperatively. Conclusions Using CAD in double-step distraction osteogenesis in the reconstruction of unilateral mandibular segmental defects has the advantages of precise diagnosis, operation planning and assuring success of operation. It has the disadvantage of a long period for the overall treatment time.