三维快速原型手术模板引导前节段截骨的准确性

Moyuan Qu, Songsong Zhu, Zhiai Hu, Yunfeng Li, B. Abotaleb, R. Bi, N. Jiang
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引用次数: 1

摘要

手术指导模板为将模拟应用到实际手术中提供了可靠的途径。然而,目前还没有设计用于前节段截骨的模板。本研究旨在介绍和评估一套用于前节段截骨术的3D快速成型手术模板。材料与方法2015年8月至2017年8月,选取17例双颌前突患者,采用基于咬合的多断面模板进行手术。通过头颅测量分析和3D叠加来评估模拟与实际术后结果的差异。随访12个月,观察并发症及复发率。结果所有患者双颌前突均得到矫正,无并发症。在影像学评估中,实际手术与计算机辅助三维模拟的差异无统计学意义(p >0.05,线性和角度的平均差异分别小于1.32mm和1.72°,三维叠加的差异小于1.4mm)。Pearson类内相关系数信度高(0.897),相关性极显著(P< 0.001)。结论本研究设计的3D打印手术模板能够安全、准确地将计算机辅助3D模拟应用到实际手术中。关键词:CAD / CAM;前节段截骨术;手术指导模板;缩突出;虚拟手术模拟。
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The accuracy of three-dimensional rapid prototyped surgical template guided anterior segmental osteotomy
Background Surgical guiding templates provided a reliable way to transfer the simulation to the actual operation. However, there was no template designed for anterior segmental osteotomy so far. The study aimed to introduce and evaluate a set of 3D rapid prototyping surgical templates used in anterior segmental osteotomy. Material and Methods From August 2015 to August 2017, 17 patients with bimaxillary protrusions were recruited and occlusal-based multi-sectional templates were applied in the surgeries. The cephalometric analysis and 3D superimposition were performed to evaluate the differences between the simulations and actual post-operative outcomes. The patients were followed-up for 12 months to evaluate the incidence rate of complications and relapse. Results Bimaxillary protrusion was corrected in all patients with no complication. In radiographic evaluations, there was no statistically significant difference between the actual operations and the computer-aided 3D simulations (p >0.05, the mean linear and angular differences were less than 1.32mm and 1.72° consequently, and 3D superimposition difference was less than 1.4mm). The Pearson intraclass correlation coefficient reliabilities were high (0.897), and the correlations were highly significant (P< 0.001). Conclusions The 3D printed surgical template designed in this study can safely and accurately transfer the computer-aided 3D simulation into real practice. Key words:CAD/CAM; anterior segmental osteotomy; surgical guiding templates; bimaxillary protrusion; virtual surgery simulation.
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