个性化钛修复体在下颌骨缺损重建中的应用
摘要
目的:探讨个性化钛修复体在下颌骨缺损修复中的临床疗效。方法:回顾性分析2011年10月至2016年12月23例下颌骨缺损患者的临床资料。通过CT扫描获取下颌骨缺损区数据,利用3D打印技术制作与对侧下颌骨形态一致的个性化钛修复体。在手术切除肿瘤的同期植入下颌骨进行缺损重建,观察术后下颌骨的形态和功能。结果:23例患者成功切除肿瘤,同期植入个性化钛修复体完成下颌骨重建,术后患者面部外形基本对称,下颌骨缺损区的重建形态及固定较好,并可以正常进食及咀嚼。结论:个性化钛修复体重建下颌骨缺损实现美观、功能重建效果确切,患者满意。手术操作简便、较传统手术缩短术中时间,是一种简便、可行的下颌骨修复重建方法,通过制作时预留植骨空间、设计截骨导板,进行精准截骨、降低制作成本可进一步提升应用空间。
引文
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[2]董青山,郭家平,李志进,等.基于快速成型技术即刻精确修复下颌骨缺损的临床研究[J].口腔医学研究,2012,28(11):1134-1137.
[3]KLEIN GT,LU Y,WANG M Y.3D printing and neurosurgeryready for prime time[J].World Neurosurg,2013,80(3):233-235.
[4]OLSZEWSKI R.Three-dimensional rapid prototyping models in cranio-maxillofacial surgery:systematic review and new clinical application[J].P Belg Roy Acad Med,2013,2(1):43-47.
[5]WONG JY,PFAHNL AC.3D printing of surgical instruments for long-duration space missions[J].Aciat space environ med.2014,85(7):758-763.
[6]MODABBER A,AYOUB N,et al.The accuracyof computer-assisted primary mandibular reconstruction withvascularizedbone flaps:iliac crest bone flap versus osteomyocutaneousfibula flap[J].Med Devices(Auckl),2014,16(7):211-217.
[7]RODBY K A,TURIN S,JACOBS R J,et al.Advances in oncologichead and neck reconstruction:systematic review and future considerat ions of virtual surgical planning and computer aideddesign/computer aided modeling[J].PlastReconstrAesthetSurg,2014,67(9):1171-1185.
[8]孙弘,孙坚.颌面功能性外科学[M].上海:第二军医大学出版社,2003:357-358
[9]蒋济金,贾暮云.钛重建板修复下颌骨缺损的常见并发症[J].青岛大学医学院学报,2016,52(1):122-124.
[10]LONI E S,HERLE P,PADDLE A,et al.Mandi bular reconstruction:meta-analysis of iliac-versus fibula-free flaps[J].ANZ J SurgSurg,2016,86(5):337-342.
[11]HIDALGO DA.Fibula free flap:a new method of mandible reconstruction[J].PlastReconstrSurg,1989,84(1):71-79.
[12]RIEDIGER D.Restoration of mast icatory funct ion by microsurgicallyrevascularized iliac crest bone grafts using enosseous implants[J].PlastReconstr Surg.1988,81(6):861-877.
[13]ARDILA JE,TORRES T,TORRES C,et al.Mandibular Reconstruction in a Patient With Rosai-Dorfman Disease[J].J Craniofac Surg.2016,27(1):e13-17.
[14]GOULART DR,KEMMOKU DT,NORITOMI PY,et al.Development of a Titanium Plate for Mandibular Angle Fractures with a Bone Defect in the Lower Border:Finite Element Analysis and Mechanical Test[J].J Oral Maxillofac Res.2015,6(3):e5.
[15]TARSITANO A,DEL CORSO G,CIOCCA L,et al.Mandibular reconstr uctions using computer-aided design/computeraided ma nufacturing:A systematic review of a defectbased reconst ructive algor ithm[J].J Craniomaxillofac Surg.2015,43(9):1785-1791.
[16]MURAKAMI K,YAMAMOTO K,SUGIURA T,e t al.Biomechanical analysis of poly-L-lactic acid and titanium plates fixated for mandibular symphyseal fracture with a conservatively treated unilateral condylar fracture using the three-dimensional finite element method[J].Dent Traumatol.2015,31(5):396-402.
[17]DROSSE I,VOLKMER E,CAPANNA R,et al.Tissue engineering for bone defect healing:an update on a multicomponent approach[J].Injury,2008,39(2):19-20.
[18]HUTMACHER DW.Scaffolds in tissue engineering bone and cartilage[J].Biomaterials,2000,21(24):2529-2543.
[19]TJOA T,MANUEL CT,LEARY RP,et al.A finite element model to simulate formation of the inverted-v deformity[J].JAMA Facial Plast Surg.2016,18(2):136-143.
[20]ESMAEILI MONIR H,YAMADA H,SAKATA N.Finite element modelling of the common carotid artery in the elderly with physiological intimal thickening using layer-specific stressreleased geometries and nonlinear elastic properties[J].Comput Methods Biomech Biomed Engin.2016,19(12):1286-1296.