中华口腔医学研究杂志(电子版)
中華口腔醫學研究雜誌(電子版)
중화구강의학연구잡지(전자판)
CHINESE JOURNAL OF STOMATOLOGICAL RESEARCH(ELECTRONIC VERSION)
2014年
5期
392-397
,共6页
梁伟强%姚媛媛%陈宇宏%冀晨阳%潘淑娟%张金明
樑偉彊%姚媛媛%陳宇宏%冀晨暘%潘淑娟%張金明
량위강%요원원%진우굉%기신양%반숙연%장금명
计算机辅助设计与制造%颌面骨缺损%修复重建
計算機輔助設計與製造%頜麵骨缺損%脩複重建
계산궤보조설계여제조%합면골결손%수복중건
Computer-aided design and computer-aided manufacturing%Maxillofacial bone defect%Plastic and reconstructive surgery
目的探讨计算机辅助设计与制造(CAD/CAM)技术制作的复合型人工骨预制体在个性化颌面骨缺损修复中的临床应用价值。方法对6例颌面骨缺损的患者利用复合人工骨进行骨缺损修复,术前对颌面骨缺损部位进行螺旋CT扫描并三维重建,应用计算机辅助设计软件、计算机辅助制造快速成型机、复合人工骨材料及一系列的工序处理后制成三维颌面模型及个性化的颌面骨预制体,术中在模型指导下将颌面骨预制体精确定位与固定。其中3例并明显皮肤软组织缺损患者,则予同期或二期行皮肤软组织缺损的修复。结果全部颌面预制体术中能准确快速的就位及固定,无预制体断裂等发生,转移修复皮肤软组织缺损的皮瓣血运良好,除1例经口内切口患者术后部分伤口裂开予二期清创缝合后伤口愈合外,余伤口愈合良好。随访6个月至4年,无预制体移位、排斥等并发症发生,双侧颌面外形基本对称,外形满意。结论应用CAD/CAM制成的个性化复合材料颌面骨预制体能达到颌面骨缺损的精确重建,有效地解决植入体塑形困难,简化了手术程序及缩短手术时间,且并发症少,效果良好,值得临床推广应用。
目的探討計算機輔助設計與製造(CAD/CAM)技術製作的複閤型人工骨預製體在箇性化頜麵骨缺損脩複中的臨床應用價值。方法對6例頜麵骨缺損的患者利用複閤人工骨進行骨缺損脩複,術前對頜麵骨缺損部位進行螺鏇CT掃描併三維重建,應用計算機輔助設計軟件、計算機輔助製造快速成型機、複閤人工骨材料及一繫列的工序處理後製成三維頜麵模型及箇性化的頜麵骨預製體,術中在模型指導下將頜麵骨預製體精確定位與固定。其中3例併明顯皮膚軟組織缺損患者,則予同期或二期行皮膚軟組織缺損的脩複。結果全部頜麵預製體術中能準確快速的就位及固定,無預製體斷裂等髮生,轉移脩複皮膚軟組織缺損的皮瓣血運良好,除1例經口內切口患者術後部分傷口裂開予二期清創縫閤後傷口愈閤外,餘傷口愈閤良好。隨訪6箇月至4年,無預製體移位、排斥等併髮癥髮生,雙側頜麵外形基本對稱,外形滿意。結論應用CAD/CAM製成的箇性化複閤材料頜麵骨預製體能達到頜麵骨缺損的精確重建,有效地解決植入體塑形睏難,簡化瞭手術程序及縮短手術時間,且併髮癥少,效果良好,值得臨床推廣應用。
목적탐토계산궤보조설계여제조(CAD/CAM)기술제작적복합형인공골예제체재개성화합면골결손수복중적림상응용개치。방법대6례합면골결손적환자이용복합인공골진행골결손수복,술전대합면골결손부위진행라선CT소묘병삼유중건,응용계산궤보조설계연건、계산궤보조제조쾌속성형궤、복합인공골재료급일계렬적공서처리후제성삼유합면모형급개성화적합면골예제체,술중재모형지도하장합면골예제체정학정위여고정。기중3례병명현피부연조직결손환자,칙여동기혹이기행피부연조직결손적수복。결과전부합면예제체술중능준학쾌속적취위급고정,무예제체단렬등발생,전이수복피부연조직결손적피판혈운량호,제1례경구내절구환자술후부분상구렬개여이기청창봉합후상구유합외,여상구유합량호。수방6개월지4년,무예제체이위、배척등병발증발생,쌍측합면외형기본대칭,외형만의。결론응용CAD/CAM제성적개성화복합재료합면골예제체능체도합면골결손적정학중건,유효지해결식입체소형곤난,간화료수술정서급축단수술시간,차병발증소,효과량호,치득림상추엄응용。
Objective To evaluate the clinical application of individual artificial bone fabrication with computer-aided design and computer-aided manufacturing technology in the reconstruction of maxillofacial bone defects. Methods Six patients with maxillofacial bone defect were observed between March 2005 and August 2010, 4 underwent reconstruction of orbital wall defects, 1 underwent reconstruction of zygomatic bone and maxillary bone defects and 1 underwent repair of hemifacial microsomia. All patients took preoperative computer tomography scan, then with computer-aided design software, rapid prototyping technology for artificial bone fabrication by manufacturers with composite materials, and series of procedures, finally got the three-dimensional maxillofacial model and artificial bone fitted to the defects. Three patients combined with skin and soft tissue defects were repaired with skin flaps simultaneously or latterly. Results All fabrications could fixed to the defect areas quickly and precisely, and all wounds healed well without any complications, except one who healed by second intention with debridement and suturing which undergone intraoral incision and resulted in part of wound dehiscence. Conclusion With composite artificial bones and combined with computer-aided design and computer-aided manufacturing technology , reconstruction of maxillofacial bone defect can be obtained easily, quickly and effectively with good result and few complications.