Simultaneous Computer-Aided Design/Computer-Aided Manufacture Bimaxillary Orthognathic Surgery and Mandibular Reconstruction Using Selective-Laser Sintered Titanium Implant
Simultaneous Computer-Aided Design/Computer-Aided Manufacture Bimaxillary Orthognathic Surgery and Mandibular Reconstruction Using Selective-Laser Sintered Titanium Implant
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DOI：
10.1097/scs.0000000000003039
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发表时间：
2016-10-01
影响因子：
0.9
通讯作者：
Huppa, Chrisopher
中科院分区：
文献类型：
--
作者：
Hatamleh, Muhanad M.;Bhamrah, Gurprit;Huppa, Chrisopher
该患者报告描述了通过三维（3D）规划、3D打印生物相容性手术晶片和3D选择性激光烧结钛种植体进行的同时双颌正颌手术和下颌骨重建。一位26岁的男性患者，因外伤导致左下颌骨缺损。左手侧下颌骨的整个身体都有缺陷，与剩余的左髁连接狭窄。他接受了18个月的正畸治疗，准备接受双颌正颌手术。先进的颅颌面软件被用于处理他的锥形束计算机断层扫描数据，以及他的上下牙弓的电子模型。计划采用Le Fort 1上颌阻生和下颌前移进行双颌手术，以实现1类切牙关系。中间和最终的手术晶片按照计划的运动进行设计，并使用生物相容性树脂进行印刷。通过将对侧右侧镜像到缺损左侧来重建缺损左侧下颌骨，目的是恢复正常的面部对称性。然后使用生物医学软件设计重建板，在计划的双颌手术和下颌骨连续性对称重建后连接髁突头和下颌骨。该板是在最先进的选择性激光烧结技术之后用钛打印的。双颌手术和下颌骨重建按计划沿着进行，同时行髂嵴植骨。该患者证实了3D计算机辅助设计/计算机辅助制造技术在优化颅颌面重建临床结局方面的优势，特别是在同时进行两项临床手术时。
This patient report describes simultaneous bimaxillary orthognathic surgery and mandibular reconstruction by means of three-dimensional (3D) planning, 3D printed biocompatible surgical wafers, and 3D selective-laser sintered titanium implant. A 26-year-old male patient presented with a left mandibular defect secondary to trauma. The whole body of the mandible on the left hand side was deficient with a narrow connection with the remaining left condyle. He had undergone orthodontic treatment for 18 months and was ready to undergo bimaxillary orthognathic surgery. Advanced cranio-maxillofacial software was used in processing his cone beam computer tomography scan data, and e-casts of his upper and lower dental arches. Bimaxillary surgery was planned with Le Fort 1 maxillary impaction and mandibular advancement to achieve a class 1 incisor relationship. Intermediate and final surgical wafers were designed following the planned movements and printed using biocompatible resin. The deficient left side of the mandible was reconstructed by means of mirror imaging the contra-lateral right side into the deficient left side with the aim of restoring normal facial symmetry. Biomedical software was then used in designing a reconstruction plate that connected the condylar head and the mandible following the planned bimaxillary surgery and mandibular continuity symmetry reconstruction. The plate was printed in titanium following state-of the-art selective laser sintering technology. The bimaxillary surgery and mandibular reconstruction were done simultaneously as planned along with an iliac-crest bone graft. This patient confirms the advantages of 3D computer-aided design/computer-aided manufacture technologies in optimizing clinical outcomes for cranio-maxillofacial reconstruction, especially when conducting two simultaneous clinical procedures.