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On the Fused Deposition Modelling of Personalised Bio-Scaffolds: Materials, Design, and Manufacturing Aspects. 个性化生物支架的熔融沉积建模:材料、设计和制造方面。
IF 3.8 3区 医学 Q2 ENGINEERING, BIOMEDICAL Pub Date : 2024-07-31 DOI: 10.3390/bioengineering11080769
Helena Cardoso Sousa, Rui B Ruben, Júlio C Viana

Bone tissue engineering (BTE) is an important field of research, essential in order to heal bone defects or replace impaired tissues and organs. As one of the most used additive manufacturing processes, 3D printing can produce biostructures in the field of tissue engineering for bones, orthopaedic tissues, and organs. Scaffold manufacturing techniques and suitable materials with final structural, mechanical properties, and the biological response of the implanted biomaterials are an essential part of BTE. In fact, the scaffold is an essential component for tissue engineering where cells can attach, proliferate, and differentiate to develop functional tissue. Fused deposition modelling (FDM) is commonly employed in the 3D printing of tissue-engineering scaffolds. Scaffolds must have a good architecture, considering the porosity, permeability, degradation, and healing capabilities. In fact, the architecture of a scaffold is crucial, influencing not only the physical and mechanical properties but also the cellular behaviours of mesenchymal stem cells. Cells placed on/or within the scaffolds is a standard approach in tissue engineering. For bio-scaffolds, materials that are biocompatible and biodegradable, and can support cell growth are the ones chosen. These include polymers like polylactic acid (PLA), polycaprolactone (PCL), and certain bioglass or composite materials. This work comprehensively integrates aspects related to the optimisation of biocompatible and biodegradable composites with the low cost, simple, and stable FDM technology to successfully prepare the best designed composite porous bone-healing scaffolds. FDM can be used to produce low-cost bone scaffolds, with a suitable porosity and permeability.

骨组织工程(BTE)是一个重要的研究领域,对于治愈骨缺损或替代受损组织和器官至关重要。作为最常用的增材制造工艺之一,3D 打印技术可以在组织工程领域制造骨骼、矫形组织和器官的生物结构。支架制造技术和具有最终结构、机械性能和植入生物材料生物反应的合适材料是 BTE 的重要组成部分。事实上,支架是组织工程的重要组成部分,细胞可以在支架上附着、增殖和分化,从而形成功能性组织。组织工程支架的三维打印通常采用熔融沉积成型(FDM)技术。考虑到孔隙率、渗透性、降解和愈合能力,支架必须具有良好的结构。事实上,支架的结构至关重要,它不仅影响物理和机械性能,还影响间充质干细胞的细胞行为。将细胞置于支架上或支架内是组织工程学的标准方法。对于生物支架,应选择具有生物相容性和生物可降解性,并能支持细胞生长的材料。这些材料包括聚乳酸(PLA)、聚己内酯(PCL)等聚合物,以及某些生物玻璃或复合材料。这项工作将生物相容性和生物可降解复合材料的优化相关方面与低成本、简单、稳定的 FDM 技术进行了全面整合,成功制备出了最佳设计的复合多孔骨愈合支架。FDM 可用于生产具有适当孔隙率和渗透性的低成本骨支架。
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引用次数: 0
Cerebral Protection Strategies in Aortic Arch Surgery-Past Developments, Current Evidence, and Future Innovation. 主动脉弓手术中的脑保护策略--过去的发展、当前的证据和未来的创新。
IF 3.8 3区 医学 Q2 ENGINEERING, BIOMEDICAL Pub Date : 2024-07-31 DOI: 10.3390/bioengineering11080775
Paul Werner, Martin Winter, Stephané Mahr, Marie-Elisabeth Stelzmueller, Daniel Zimpfer, Marek Ehrlich

Surgery of the aortic arch remains a complex procedure, with neurological events such as stroke remaining its most dreaded complications. Changes in surgical technique and the continuous innovation in neuroprotective strategies have led to a significant decrease in cerebral and spinal events. Different modes of cerebral perfusion, varying grades of hypothermia, and a number of pharmacological strategies all aim to reduce hypoxic and ischemic cerebral injury, yet there is no evidence indicating the clear superiority of one method over another. While surgical results continue to improve, novel hybrid and interventional techniques are just entering the stage and the question of optimal neuroprotection remains up to date. Within this perspective statement, we want to shed light on the current evidence and controversies of cerebral protection in aortic arch surgery, as well as what is on the horizon in this fast-evolving field. We further present our institutional approach as a large tertiary aortic reference center.

主动脉弓手术仍是一项复杂的手术,中风等神经系统事件仍是其最可怕的并发症。手术技术的改变和神经保护策略的不断创新已使脑部和脊柱事件显著减少。不同的脑灌注模式、不同程度的低体温以及多种药物策略都旨在减少缺氧和缺血性脑损伤,但目前还没有证据表明一种方法明显优于另一种方法。虽然手术效果不断改善,但新型混合和介入技术才刚刚进入临床阶段,最佳神经保护的问题仍有待解决。在这篇观点陈述中,我们希望阐明主动脉弓手术中脑保护的现有证据和争议,以及这一快速发展领域的前景。作为一家大型三级主动脉参考中心,我们将进一步介绍本机构的方法。
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引用次数: 0
An Unsupervised Error Detection Methodology for Detecting Mislabels in Healthcare Analytics. 用于检测医疗保健分析中误标的无监督错误检测方法。
IF 3.8 3区 医学 Q2 ENGINEERING, BIOMEDICAL Pub Date : 2024-07-31 DOI: 10.3390/bioengineering11080770
Pei-Yuan Zhou, Faith Lum, Tony Jiecao Wang, Anubhav Bhatti, Surajsinh Parmar, Chen Dan, Andrew K C Wong

Medical datasets may be imbalanced and contain errors due to subjective test results and clinical variability. The poor quality of original data affects classification accuracy and reliability. Hence, detecting abnormal samples in the dataset can help clinicians make better decisions. In this study, we propose an unsupervised error detection method using patterns discovered by the Pattern Discovery and Disentanglement (PDD) model, developed in our earlier work. Applied to the large data, the eICU Collaborative Research Database for sepsis risk assessment, the proposed algorithm can effectively discover statistically significant association patterns, generate an interpretable knowledge base for interpretability, cluster samples in an unsupervised learning manner, and detect abnormal samples from the dataset. As shown in the experimental result, our method outperformed K-Means by 38% on the full dataset and 47% on the reduced dataset for unsupervised clustering. Multiple supervised classifiers improve accuracy by an average of 4% after removing abnormal samples by the proposed error detection approach. Therefore, the proposed algorithm provides a robust and practical solution for unsupervised clustering and error detection in healthcare data.

由于主观测试结果和临床变异,医疗数据集可能不平衡并包含误差。原始数据质量差会影响分类的准确性和可靠性。因此,检测数据集中的异常样本可以帮助临床医生做出更好的决策。在本研究中,我们提出了一种无监督错误检测方法,该方法使用的模式是我们早期工作中开发的模式发现和纠错(PDD)模型所发现的模式。将该算法应用于用于脓毒症风险评估的 eICU 协作研究数据库这一大型数据,可以有效地发现具有统计意义的关联模式,生成可解释性知识库,以无监督学习的方式对样本进行聚类,并从数据集中检测出异常样本。实验结果表明,在无监督聚类方面,我们的方法在完整数据集上比 K-Means 高出 38%,在缩小数据集上比 K-Means 高出 47%。在使用所提出的错误检测方法剔除异常样本后,多重监督分类器的准确率平均提高了 4%。因此,所提出的算法为医疗数据的无监督聚类和错误检测提供了一种稳健实用的解决方案。
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引用次数: 0
Three-Dimensional Bioprinting: A Comprehensive Review for Applications in Tissue Engineering and Regenerative Medicine. 三维生物打印:组织工程和再生医学应用综述》。
IF 3.8 3区 医学 Q2 ENGINEERING, BIOMEDICAL Pub Date : 2024-07-31 DOI: 10.3390/bioengineering11080777
Nicholas A Mirsky, Quinn T Ehlen, Jason A Greenfield, Michael Antonietti, Blaire V Slavin, Vasudev Vivekanand Nayak, Daniel Pelaez, David T Tse, Lukasz Witek, Sylvia Daunert, Paulo G Coelho

Since three-dimensional (3D) bioprinting has emerged, it has continuously to evolved as a revolutionary technology in surgery, offering new paradigms for reconstructive and regenerative medical applications. This review highlights the integration of 3D printing, specifically bioprinting, across several surgical disciplines over the last five years. The methods employed encompass a review of recent literature focusing on innovations and applications of 3D-bioprinted tissues and/or organs. The findings reveal significant advances in the creation of complex, customized, multi-tissue constructs that mimic natural tissue characteristics, which are crucial for surgical interventions and patient-specific treatments. Despite the technological advances, the paper introduces and discusses several challenges that remain, such as the vascularization of bioprinted tissues, integration with the host tissue, and the long-term viability of bioprinted organs. The review concludes that while 3D bioprinting holds substantial promise for transforming surgical practices and enhancing patient outcomes, ongoing research, development, and a clear regulatory framework are essential to fully realize potential future clinical applications.

自三维(3D)生物打印技术出现以来,它作为外科领域的一项革命性技术不断发展,为重建和再生医疗应用提供了新的范例。本综述重点介绍了过去五年中三维打印技术(特别是生物打印技术)在多个外科学科中的应用。所采用的方法包括对近期文献的回顾,重点关注三维生物打印组织和/或器官的创新与应用。研究结果表明,在模拟天然组织特征的复杂、定制、多组织构建方面取得了重大进展,这对于外科干预和特定患者的治疗至关重要。尽管取得了技术进步,但论文介绍并讨论了仍然存在的几个挑战,如生物打印组织的血管化、与宿主组织的整合以及生物打印器官的长期存活性。综述总结道,虽然三维生物打印技术在改变外科手术方法和提高患者疗效方面前景广阔,但要充分实现未来潜在的临床应用,持续的研究、开发和明确的监管框架至关重要。
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引用次数: 0
Machine Learning-Enhanced Estimation of Cellular Protein Levels from Bright-Field Images. 机器学习增强型明视野图像细胞蛋白质水平估算。
IF 3.8 3区 医学 Q2 ENGINEERING, BIOMEDICAL Pub Date : 2024-07-31 DOI: 10.3390/bioengineering11080774
Takeshi Tohgasaki, Arisa Touyama, Shohei Kousai, Kaita Imai

In this study, we aimed to develop a novel method for non-invasively determining intracellular protein levels, which is essential for understanding cellular phenomena. This understanding hinges on insights into gene expression, cell morphology, dynamics, and intercellular interactions. Traditional cell analysis techniques, such as immunostaining, live imaging, next-generation sequencing, and single-cell analysis, despite rapid advancements, face challenges in comprehensively integrating gene and protein expression data with spatiotemporal information. Leveraging advances in machine learning for image analysis, we designed a new model to estimate cellular biomarker protein levels using a blend of phase-contrast and fluorescent immunostaining images of epidermal keratinocytes. By iterating this process across various proteins, our model can estimate multiple protein levels from a single phase-contrast image. Additionally, we developed a system for analyzing multiple protein expression levels alongside spatiotemporal data through live imaging and phase-contrast methods. Our study offers valuable tools for cell-based research and presents a new avenue for addressing molecular biological challenges.

在这项研究中,我们旨在开发一种非侵入式测定细胞内蛋白质水平的新方法,这对理解细胞现象至关重要。这种理解取决于对基因表达、细胞形态、动态和细胞间相互作用的深入了解。传统的细胞分析技术,如免疫染色、活体成像、新一代测序和单细胞分析,尽管发展迅速,但在将基因和蛋白质表达数据与时空信息全面整合方面仍面临挑战。利用机器学习在图像分析方面的进步,我们设计了一个新模型,利用表皮角质细胞的相位对比和荧光免疫染色图像来估算细胞生物标记蛋白水平。通过在各种蛋白质之间重复这一过程,我们的模型可以从单张相位对比图像中估算出多种蛋白质水平。此外,我们还开发了一套系统,可通过实时成像和相位对比方法分析多种蛋白质的表达水平以及时空数据。我们的研究为基于细胞的研究提供了宝贵的工具,并为解决分子生物学难题提供了新的途径。
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引用次数: 0
The Effect of Aligned and Random Electrospun Fibers Derived from Porcine Decellularized ECM on Mesenchymal Stem Cell-Based Treatments for Spinal Cord Injury. 由猪脱细胞 ECM 制成的对齐和随机电纺纤维对基于间充质干细胞的脊髓损伤治疗的影响。
IF 3.8 3区 医学 Q2 ENGINEERING, BIOMEDICAL Pub Date : 2024-07-31 DOI: 10.3390/bioengineering11080772
Zhiqiang Tai, Jiashang Liu, Bixue Wang, Shu Chen, Changsheng Liu, Xi Chen

The impact of traumatic spinal cord injury (SCI) can be extremely devastating, as it often results in the disruption of neural tissues, impeding the regenerative capacity of the central nervous system. However, recent research has demonstrated that mesenchymal stem cells (MSCs) possess the capacity for multi-differentiation and have a proven track record of safety in clinical applications, thus rendering them effective in facilitating the repair of spinal cord injuries. It is urgent to develop an aligned scaffold that can effectively load MSCs for promoting cell aligned proliferation and differentiation. In this study, we prepared an aligned nanofiber scaffold using the porcine decellularized spinal cord matrix (DSC) to induce MSCs differentiation for spinal cord injury. The decellularization method removed 87% of the immune components while retaining crucial proteins in DSC. The electrospinning technique was employed to fabricate an aligned nanofiber scaffold possessing biocompatibility and a diameter of 720 nm. In in vitro and in vivo experiments, the aligned nanofiber scaffold induces the aligned growth of MSCs and promotes their differentiation into neurons, leading to tissue regeneration and nerve repair after spinal cord injury. The approach exhibits promising potential for the future development of nerve regeneration scaffolds for spinal cord injury treatment.

外伤性脊髓损伤(SCI)的影响极具破坏性,因为它通常会导致神经组织的破坏,阻碍中枢神经系统的再生能力。然而,最近的研究表明,间充质干细胞(MSCs)具有多重分化能力,在临床应用中的安全性也得到了证实,因此能有效促进脊髓损伤的修复。当务之急是开发一种能有效负载间充质干细胞的配位支架,以促进细胞的配位增殖和分化。在这项研究中,我们利用猪脱细胞脊髓基质(DSC)制备了一种排列整齐的纳米纤维支架,以诱导间充质干细胞分化,从而治疗脊髓损伤。脱细胞方法去除了 87% 的免疫成分,同时保留了 DSC 中的重要蛋白质。电纺丝技术用于制造具有生物相容性的排列整齐的纳米纤维支架,其直径为 720 nm。在体外和体内实验中,排列整齐的纳米纤维支架能诱导间充质干细胞排列整齐地生长,并促进它们分化成神经元,从而实现脊髓损伤后的组织再生和神经修复。该方法为未来开发用于脊髓损伤治疗的神经再生支架提供了广阔的前景。
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引用次数: 0
A Novel Time-Frequency Parameterization Method for Oscillations in Specific Frequency Bands and Its Application on OPM-MEG. 特定频段振荡的新型时频参数化方法及其在 OPM-MEG 上的应用
IF 3.8 3区 医学 Q2 ENGINEERING, BIOMEDICAL Pub Date : 2024-07-31 DOI: 10.3390/bioengineering11080773
Xiaoyu Liang, Ruonan Wang, Huanqi Wu, Yuyu Ma, Changzeng Liu, Yang Gao, Dexin Yu, Xiaolin Ning

Time-frequency parameterization for oscillations in specific frequency bands reflects the dynamic changes in the brain. It is related to cognitive behavior and diseases and has received significant attention in neuroscience. However, many studies do not consider the impact of the aperiodic noise and neural activity, including their time-varying fluctuations. Some studies are limited by the low resolution of the time-frequency spectrum and parameter-solved operation. Therefore, this paper proposes super-resolution time-frequency periodic parameterization of (transient) oscillation (STPPTO). STPPTO obtains a super-resolution time-frequency spectrum with Superlet transform. Then, the time-frequency representation of oscillations is obtained by removing the aperiodic component fitted in a time-resolved way. Finally, the definition of transient events is used to parameterize oscillations. The performance of this method is validated on simulated data and its reliability is demonstrated on magnetoencephalography. We show how it can be used to explore and analyze oscillatory activity under rhythmic stimulation.

特定频段振荡的时频参数化反映了大脑的动态变化。它与认知行为和疾病有关,在神经科学领域受到极大关注。然而,许多研究并没有考虑非周期性噪声和神经活动的影响,包括它们的时变波动。一些研究受限于时频谱的低分辨率和参数求解操作。因此,本文提出了(瞬态)振荡的超分辨率时频周期参数化(STPPTO)。STPPTO 通过 Superlet 变换获得超分辨率时频谱。然后,通过去除以时间分辨方式拟合的非周期性分量,获得振荡的时频表示。最后,利用瞬态事件的定义来确定振荡的参数。这种方法的性能在模拟数据上得到了验证,其可靠性也在脑磁图上得到了证明。我们展示了该方法如何用于探索和分析节律刺激下的振荡活动。
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引用次数: 0
Biohacking Nerve Repair: Novel Biomaterials, Local Drug Delivery, Electrical Stimulation, and Allografts to Aid Surgical Repair. 生物黑客神经修复:辅助手术修复的新型生物材料、局部给药、电刺激和同种异体移植。
IF 3.8 3区 医学 Q2 ENGINEERING, BIOMEDICAL Pub Date : 2024-07-31 DOI: 10.3390/bioengineering11080776
Jordan R Crabtree, Chilando M Mulenga, Khoa Tran, Konstantin Feinberg, J Paul Santerre, Gregory H Borschel

The regenerative capacity of the peripheral nervous system is limited, and peripheral nerve injuries often result in incomplete healing and poor outcomes even after repair. Transection injuries that induce a nerve gap necessitate microsurgical intervention; however, even the current gold standard of repair, autologous nerve graft, frequently results in poor functional recovery. Several interventions have been developed to augment the surgical repair of peripheral nerves, and the application of functional biomaterials, local delivery of bioactive substances, electrical stimulation, and allografts are among the most promising approaches to enhance innate healing across a nerve gap. Biocompatible polymers with optimized degradation rates, topographic features, and other functions provided by their composition have been incorporated into novel nerve conduits (NCs). Many of these allow for the delivery of drugs, neurotrophic factors, and whole cells locally to nerve repair sites, mitigating adverse effects that limit their systemic use. The electrical stimulation of repaired nerves in the perioperative period has shown benefits to healing and recovery in human trials, and novel biomaterials to enhance these effects show promise in preclinical models. The use of acellular nerve allografts (ANAs) circumvents the morbidity of donor nerve harvest necessitated by the use of autografts, and improvements in tissue-processing techniques may allow for more readily available and cost-effective options. Each of these interventions aid in neural regeneration after repair when applied independently, and their differing forms, benefits, and methods of application present ample opportunity for synergistic effects when applied in combination.

外周神经系统的再生能力有限,外周神经损伤往往导致愈合不完全,即使修复后效果也不佳。导致神经间隙的横断损伤需要进行显微外科干预;然而,即使是目前的黄金修复标准--自体神经移植,也经常导致功能恢复不佳。目前已开发出多种干预措施来增强外周神经的手术修复,其中应用功能性生物材料、局部输送生物活性物质、电刺激和异体移植是最有希望增强神经间隙先天性愈合的方法。生物相容性聚合物具有优化的降解率、地形特征以及由其成分提供的其他功能,已被纳入新型神经导管(NC)中。其中许多都能在局部向神经修复部位输送药物、神经营养因子和全细胞,减轻限制其全身使用的不良影响。在围手术期对修复后的神经进行电刺激已在人体试验中显示出对愈合和恢复的益处,而在临床前模型中,用于增强这些效果的新型生物材料也显示出了良好的前景。无细胞神经异体移植物(ANAs)的使用避免了因使用自体移植物而导致的供体神经采集的发病率,组织加工技术的改进可能会带来更多易于获得且具有成本效益的选择。这些干预措施在单独应用时都有助于修复后的神经再生,而在联合应用时,它们不同的形式、益处和应用方法为协同效应提供了充分的机会。
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引用次数: 0
The Role and Applications of Artificial Intelligence in Dental Implant Planning: A Systematic Review. 人工智能在牙科种植规划中的作用和应用:系统回顾
IF 3.8 3区 医学 Q2 ENGINEERING, BIOMEDICAL Pub Date : 2024-07-31 DOI: 10.3390/bioengineering11080778
Monica Macrì, Vincenzo D'Albis, Giuseppe D'Albis, Marta Forte, Saverio Capodiferro, Gianfranco Favia, Abdulrahman Omar Alrashadah, Victor Diaz-Flores García, Felice Festa

Artificial intelligence (AI) is revolutionizing dentistry, offering new opportunities to improve the precision and efficiency of implantology. This literature review aims to evaluate the current evidence on the use of AI in implant planning assessment. The analysis was conducted through PubMed and Scopus search engines, using a combination of relevant keywords, including "artificial intelligence implantology", "AI implant planning", "AI dental implant", and "implantology artificial intelligence". Selected articles were carefully reviewed to identify studies reporting data on the effectiveness of AI in implant planning. The results of the literature review indicate a growing interest in the application of AI in implant planning, with evidence suggesting an improvement in precision and predictability compared to traditional methods. The summary of the obtained findings by the included studies represents the latest AI developments in implant planning, demonstrating its application for the automated detection of bones, the maxillary sinus, neuronal structure, and teeth. However, some disadvantages were also identified, including the need for high-quality training data and the lack of standardization in protocols. In conclusion, the use of AI in implant planning presents promising prospects for improving clinical outcomes and optimizing patient management. However, further research is needed to fully understand its potential and address the challenges associated with its implementation in clinical practice.

人工智能(AI)正在彻底改变牙科医学,为提高种植的精确度和效率提供了新的机遇。本文献综述旨在评估目前在种植规划评估中使用人工智能的证据。分析通过 PubMed 和 Scopus 搜索引擎进行,使用的相关关键词包括 "人工智能种植"、"人工智能种植规划"、"人工智能牙科种植 "和 "人工智能种植"。对所选文章进行了仔细审阅,以确定报告人工智能在种植规划中的有效性的研究数据。文献综述的结果表明,人们对人工智能在种植规划中的应用越来越感兴趣,有证据表明,与传统方法相比,人工智能在精确度和可预测性方面都有所提高。所纳入研究的结论摘要代表了人工智能在种植规划中的最新发展,证明了其在骨骼、上颌窦、神经元结构和牙齿自动检测中的应用。不过,也发现了一些缺点,包括需要高质量的训练数据和缺乏标准化协议。总之,人工智能在种植规划中的应用为改善临床效果和优化患者管理带来了广阔的前景。然而,要想充分了解其潜力并解决在临床实践中应用所面临的挑战,还需要进一步的研究。
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引用次数: 0
Reverse Engineering Orthognathic Surgery and Orthodontics in Individuals with Cleft Lip and/or Palate: A Case Report. 唇裂和/或腭裂患者的逆向工程正颌外科手术和正畸:病例报告。
IF 3.8 3区 医学 Q2 ENGINEERING, BIOMEDICAL Pub Date : 2024-07-31 DOI: 10.3390/bioengineering11080771
Jaemin Ko, Mark M Urata, Jeffrey A Hammoudeh, Dennis-Duke Yamashita, Stephen L-K Yen

This case report presents a virtual treatment simulation of the orthodontic treatment and surgery-first orthognathic surgery employed to treat a patient with a repaired unilateral cleft lip and alveolus with Class III malocclusion and lower third facial asymmetry. The patient exhibited a negative overjet of 9 mm, a missing lower right second premolar, and a 5 mm gap between the upper right central and lateral incisors with midline discrepancy. The three-dimensional virtual planning began with virtual pre-surgical orthodontics, followed by the positioning of the facial bones and teeth in their ideal aesthetic and functional positions. The sequence of steps needed to achieve this outcome was then reverse-engineered and recorded using multiplatform Nemostudio software (Nemotec, Madrid, Spain), which facilitated both surgical and orthodontic planning. The treatment included a two-piece segmental maxillary osteotomy for dental space closure, a LeFort I maxillary advancement, and a mandibular setback with bilateral sagittal split osteotomy to correct the skeletal underbite and asymmetry. A novel approach was employed by pre-treating the patient for orthognathic surgeries at age 11, seven years prior to the surgery. This early phase of orthodontic treatment aligned the patient's teeth and established the dental arch form. The positions of the teeth were maintained with retainers, eliminating the need for pre-surgical orthodontics later. This early phase of treatment significantly reduced the treatment time. The use of software to predict all the necessary steps for surgery and post-surgical orthodontic tooth movements made this approach possible. Multi-step virtual planning can be a powerful tool for analyzing complex craniofacial problems that require multidisciplinary care, such as cleft lip and/or palate.

本病例报告通过虚拟治疗模拟,介绍了采用正畸治疗和手术先行正颌外科手术治疗一名单侧唇裂和齿槽裂修复并伴有 III 级错颌畸形和下第三面部不对称的患者的情况。患者有 9 毫米的负过咬合,右下第二前磨牙缺失,右上中切牙和侧切牙之间有 5 毫米的间隙,中线不一致。三维虚拟规划从虚拟术前正畸开始,然后将面部骨骼和牙齿定位到理想的美学和功能位置。然后使用多平台 Nemostudio 软件(Nemotec,西班牙马德里)对实现这一结果所需的步骤序列进行逆向设计和记录,这为手术和正畸规划提供了便利。治疗包括用于牙间隙闭合的两件式分段上颌骨截骨术、LeFort I 上颌骨前移术和下颌骨后移加双侧矢状劈开截骨术,以矫正骨骼咬合不足和不对称。我们采用了一种新颖的方法,在手术前七年,即患者 11 岁时对其进行正颌手术的前期治疗。早期的正畸治疗将患者的牙齿排列整齐,并建立了牙弓形态。牙齿的位置通过保持器得以保持,因此无需再进行手术前的正畸治疗。这一早期治疗阶段大大缩短了治疗时间。使用软件预测手术和手术后牙齿矫正移动的所有必要步骤使这种方法成为可能。多步骤虚拟规划是分析唇裂和/或腭裂等需要多学科治疗的复杂颅面问题的有力工具。
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引用次数: 0
期刊
Bioengineering
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