评估用于引导颌面部骨内活检的 3D 打印支架

Wael Nomeir, Mervat M. Khalil, Ahmed O. Sweedan, Hend Helmy
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摘要

背景:如果病变太小、太靠近重要组织或太难进入,活检可能很难进行。例如,切除和切开、细针(有或没有 US 引导)、核心活检(有或没有 US 引导)以及其他传统活检程序。目的评估 3D 打印牙齿支撑支架在骨内病变活检中的功效。材料与方法:12 名颌骨内病变患者。所有参与者均从亚历山大大学牙科学院口腔颌面外科门诊随机招募。样本量由 G Power(3.1.9.2 版)按照以下标准计算得出:研究功率为 80%,α误差为 5%。根据两个独立平均值之间的差值确定每组样本量为 6 名患者,考虑到随访病例的缺失,汇总的 SD=0.48 mm。使用手术导板和穿刺针进行活检,术后通过锥形束计算机断层扫描(CBCT)检查结果。结果:规划软件和相关(数字创建)活检筒用于测试术后低剂量 CBCT 的精确度。钻头的虚拟计划位置与实际位置之间的水平偏离角度从 0.38 度到 0.95 度不等,平均值为 0.70 度,标准偏差为 0.18 度。结论:模板引导下的颌骨活检似乎是传统方法的一种替代方法,可获得可预测和安全的活检结果,创伤和风险相对较低。
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EVALUATION OF 3D PRINTED STENTS FOR GUIDED INTRABONY MAXILLOFACIAL BIOPSIES
BACKGROUND: Biopsies may be difficult to do if the lesions are too small, too near to vital tissues, or too tough to access. Examples include excision and incision, fine needle (with or without US guidance), core biopsy (with or without US guidance), and other traditional biopsy procedures. OBJECTIVES: To evaluate the efficacy of the 3D printed tooth-supported stent in biopsy for intra-bony lesions. MATERIALS AND METHODS: 12 individuals with intra-bony lesions in the jaw. All participants were recruited at random from the Oral and Maxillofacial Surgery outpatient clinic at the University of Alexandria's School of Dentistry. The sample size was calculated by G Power, version 3.1.9.2 with the following criteria: 80% study power and 5% alpha error. The sample size was determined to be 6 patients per group based on the difference between two independent means using pooled SD=0.48 mm to account for missing follow-up cases. Biopsies were obtained using a surgical guide and a trephine bur, and the findings were examined by Cone beam computed tomography (CBCT) following the surgery. RESULTS: The planning software and the related (digitally created) biopsy cylinder were used to test the precision of the postoperative low-dose CBCT. The horizontal angle of departure between a drill's virtually planned location and its actual placement ranged from 0.38 degrees to 0.95 degrees, with a mean of 0.70 degrees and a standard deviation of 0.18 degrees. CONCLUSION: Template-guided biopsy of the jawbone seems to be an alternative to a conventional approach with possibility of obtaining predictable and safe biopsies with comparatively low invasiveness and risk.
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