CAJ | 학술논문

目的以3D数字化技术为基础,对颞下颌关节损伤的患者进行精确的、个体化的治疗.方法术前对患者行CT扫描,根据三维CT数据,应用快速成型技术制作真实大小的上下颌骨模型;根据3D数字化测量结果,订制颞下颌关节(TMJ Concepts)假体;于患者的颌骨模型上,模拟人工颞下颌关节置换.2010年2月至2012年11月,按模拟手术设计行全颞下颌关节置换术2例(双侧置换术1例,单侧置换术1例),人工髁状突(半关节)置换术4例.结果 ①个体化全颞下颌关节假体置换手术后,术区均无疼痛,无张口受限.术后3个月颌骨曲面断层片显示:双侧人工颞下颌关节窝与人工髁状突的相对位置正常.②个体化半关节置换术后,伤口均一期愈合,移植骨均成活,局部无明显肿胀,影像学检查均显示下颌骨外形得以保留.术后3个月及1年随访,面部左右基本对称,患者及家属对术后外形满意.结论在3D数字化技术辅助下,采用双侧个体化颞下颌全关节同期置换和个体化半颞下颌关节置换均是治疗颞下颌关节损伤的理想方法.
목적 이3D수자화기술위기출,대섭하합관절손상적환자진행정학적、개체화적치료.방법 술전대환자행CT소묘,근거삼유CT수거,응용쾌속성형기술제작진실대소적상하합골모형;근거3D수자화측량결과,정제섭하합관절(TMJ Concepts)가체;우환자적합골모형상,모의인공섭하합관절치환.2010년2월지2012년11월,안모의수술설계행전섭하합관절치환술2례(쌍측치환술1례,단측치환술1례),인공과상돌(반관절)치환술4례.결과 ①개체화전섭하합관절가체치환수술후,술구균무동통,무장구수한.술후3개월합골곡면단층편현시:쌍측인공섭하합관절와여인공과상돌적상대위치정상.②개체화반관절치환술후,상구균일기유합,이식골균성활,국부무명현종창,영상학검사균현시하합골외형득이보류.술후3개월급1년수방,면부좌우기본대칭,환자급가속대술후외형만의.결론 재3D수자화기술보조하,채용쌍측개체화섭하합전관절동기치환화개체화반섭하합관절치환균시치료섭하합관절손상적이상방법.
Objective To investigate the accurate and individual treatment of temporomandibular joint(TMJ) injury based on 3D digital technology.Methods Maxillo-mandibular model was made using rapid prototyping technology based on the pre-operation 3D CT results.According to the 3D digital measurement results,TMJ concepts were ordered and the prosthesis was used to simulate the replacement surgery on the model.Then the joint replacement surgery was performed afterward.Results ①After total replacement of TMJ,no pain happened and mouth open was not limited.Three months later,the joint position was normal and stable.The month open width was 4 cm.②After condyle replacement,primary healing was achieved with complete survival of bone graft.No edema was seen.Symmetric facial appearance was satisfactory.Conclusions Bilateral individual prosthesis for total TMJ or condyle replacement is an ideal method for TMJ injury.