Evaluation of computer-assisted mandibular reconstruction with vascularized iliac crest bone graft compared to conventional surgery: a randomized prospective clinical trial.
Evaluation of computer-assisted mandibular reconstruction with vascularized iliac crest bone graft compared to conventional surgery: a randomized prospective clinical trial.
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DOI：
10.1186/1745-6215-15-114
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发表时间：
2014-04-09
期刊：
影响因子：
2.5
通讯作者：
Modabber A
中科院分区：
文献类型：
--
作者：
Ayoub N;Ghassemi A;Rana M;Gerressen M;Riediger D;Hölzle F;Modabber A
计算机辅助手术在下颌骨重建中发挥着越来越重要的作用，以确保最佳的咀嚼功能和审美效果。在一项前瞻性研究设计中，20名患者被随机分配到计算机辅助或传统的带血管髂骨移植下颌重建组。虚拟手术计划基于术前ct数据，使用特定的手术计划软件。快速原型向导将虚拟手术计划转移到手术现场。术中测量移植物缺血时间、重建时间、移植物塑形时间和去骨量。此外，计算手术前后髁间距离的差异。与常规手术相比，计算机辅助手术缩短了移植缺血时间（P < 0.005）和缺损重建时间（P < 0.001）。常规手术在供体部位锯切和成形的时间较短（P < 0.005）；因此，手术总时间没有变化（P = 0.527）。计算机辅助组取骨量与缺损大小相等，而常规组移植骨量平均超过缺损位置16.8±5.6 mm （P < 0.001）。与常规组相比，计算机辅助组手术前后对髁间距离的影响较小（P < 0.001）。本研究表明，计算机辅助手术可以减少下颌缺损重建的时间，从而减少移植缺血时间。在计算机辅助组中，髂骨供区缺损缩小，术后髁位置改变较少，降低了术后并发症和供区发病率的可能风险。DRKS00005181。
Computer-assisted surgery plays an increasingly important role in mandibular reconstruction, ensuring the best possible masticatory function and aesthetic outcome. Twenty patients were randomly assigned to computer-assisted or conventional mandibular reconstruction with vascularized iliac crest bone graft in a prospective study design. Virtual surgical planning was based on preoperative CT-data using specific surgical planning software. A rapid prototyping guide transferred the virtual surgery plan to the operation site. During surgery the transplant ischemic time, reconstruction time, time for shaping the transplant and amount of bone removed were measured. Additionally, the difference in the intercondylar distance before and after surgery was calculated. Computer-assisted surgery shortened the time of transplant ischemia (P < 0.005) and defect reconstruction (P < 0.001) compared to conventional surgery. The time to saw and shape the transplant at the donor site was shorter using conventional surgery (P < 0.005); therefore, the overall time for surgery didn’t change (P = 0.527). In the computer-assisted group, the amount of bone harvested equaled the defect size, whereas the transplant size in the conventional group exceeded the defect site by 16.8 ± 5.6 mm (P < 0.001) on average. The intercondylar distance before compared to after surgery was less affected in the computer-assisted than in the conventional group (P < 0.001). The presented study shows that computer-assisted surgery can help reduce the time for mandibular defect reconstruction and consequently the transplant ischemic time. In the computer-assisted group, the iliac crest donor site defect was downsized and the postoperative condyle position was less altered, reducing possible risks of postoperative complications and donor site morbidity. DRKS00005181.
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DOI：
10.1054/ijom.2002.0278
发表时间：
2002-08-01
影响因子：
2.4
作者：
Troulis, MJ;Everett, R;Kaban, LB
通讯作者：
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DOI：
10.1055/s-0028-1109204
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2009-07-01
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影响因子：
1.9
作者：
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DOI：
10.1002/rcs.456
发表时间：
2012-06-01
影响因子：
2.5
作者：
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通讯作者：
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