选区激光烧结技术在复杂颌面骨骨折中的临床应用研究
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摘要
目的:
利用选区激光烧结技术对干燥头颅骨进行复制,研究激光烧结技术精度,研究建立颌面部复杂骨折内固定的快速成型系统,并通过二例骨折的辅助修复,验证该系统的可行性和实用性。
材料与方法:
1、本课题对一例干燥头颅骨标本进行螺旋CT扫描,层厚1.0mm,螺距1.0,并进行三维重建, CT图像进行灰度、对比参数的调整后,导入MIMICS8.1软件,进行滤波,二值化,轮廓提取,分割,插值等处理,矢量叠加后得到头颅骨的三维模型,转化为STL格式文件,输入快速成形机,加工得到头颅骨的三维仿真模型。
2、应用选区激光烧结快速成型系统对二例颌面部复杂骨的病人进行颌骨骨折区域的模型复制,并在模型上进行手术设计,预制钛板,模拟手术过程,并以此为参考对病人进行骨折内固定修复。术后进行评价,以验证选区激光烧结快速成型系统临床应用的可行性。
结果:
1、分别测量头颅骨标本及模型x,y,z方向的距离,头颅骨标本及模型部分解剖区的厚度。在外轮廓上,在x,y,z三个方向精度可达1mm左右,复制所得头颅骨模型与标本解部外形基本一致。在骨质较薄及锐区,精度较低,最大误差达1.5mm。制作费用降低,制作过程缩短,为临床的使用奠定了基础。
2、应用选区激光烧结快速成型系统辅助对二例颌面部复杂骨的病人进行坚固内固定修复,缩短了手术时间,较好的恢复了面部形态及咬合功能。手术效果令人满意。
结论:
反求工程与选区激光烧结快速成型技术辅助完成颌面骨复杂骨折的坚固内固定,降低了手术难度,提高了手术的精度,缩短了手术时间,解决了在颌面骨复杂骨折治疗过程中骨折复位难,面形以及咬合功能恢复不理想,手术时间较长等问题,在颌骨复杂骨折整复中具有独特的优势,具有较好的应用前景。
1Object:
The purpose of this research is to study the precision of the selective laser singtering model, create a system technique for maxillofacial fracture and apply the technique for 2 patients to complete the method.
Material and method:
1. spiral CT scans to a dried cranial bone sample, thickness at 1.0mm intervals, were generated on spiral CT scanning system. Surface reconstruction was done for three images. The paper gives a method in which the filtration, binarization, bone’s contour extraction and vectorization is done orderly. And CT data was converted to STL format. The STL file was inputted into the rapid apparatus. The 3D stereo-temporal bone physical model was built layer by layer.
2. Head spiral CT scan was given to a patient who had maxillofacial fracture from an accident. The 3D stereo-temporal bone physical model was manufactured by selective laser singtering from the digitized data. To design of the operation, to prefabricate the titanium plate and to simulate the operation process. Then the operation was carried on patients by this. Evaluate the operation effect.
Result:
1. Physical model of the cranial bone was measured at x y z directions. The precision on the outline of the model was about 1mm, according to the dried cranial bone sample. But, the error was about 1.5mm on the thick and sharp parts. In this research, the experience and time consuming was lower than before.
2. The selective laser singtering system technique for maxillofacial fracture and apply the technique for patients to complete the method. This technique can recover the face form and function of the occlusion.
Conclusion:
The selective laser singtering system technique is helpful and useful in maxillofacial fracture. It may be widely used in future.
利用选区激光烧结技术对干燥头颅骨进行复制,研究激光烧结技术精度,研究建立颌面部复杂骨折内固定的快速成型系统,并通过二例骨折的辅助修复,验证该系统的可行性和实用性。
材料与方法:
1、本课题对一例干燥头颅骨标本进行螺旋CT扫描,层厚1.0mm,螺距1.0,并进行三维重建, CT图像进行灰度、对比参数的调整后,导入MIMICS8.1软件,进行滤波,二值化,轮廓提取,分割,插值等处理,矢量叠加后得到头颅骨的三维模型,转化为STL格式文件,输入快速成形机,加工得到头颅骨的三维仿真模型。
2、应用选区激光烧结快速成型系统对二例颌面部复杂骨的病人进行颌骨骨折区域的模型复制,并在模型上进行手术设计,预制钛板,模拟手术过程,并以此为参考对病人进行骨折内固定修复。术后进行评价,以验证选区激光烧结快速成型系统临床应用的可行性。
结果:
1、分别测量头颅骨标本及模型x,y,z方向的距离,头颅骨标本及模型部分解剖区的厚度。在外轮廓上,在x,y,z三个方向精度可达1mm左右,复制所得头颅骨模型与标本解部外形基本一致。在骨质较薄及锐区,精度较低,最大误差达1.5mm。制作费用降低,制作过程缩短,为临床的使用奠定了基础。
2、应用选区激光烧结快速成型系统辅助对二例颌面部复杂骨的病人进行坚固内固定修复,缩短了手术时间,较好的恢复了面部形态及咬合功能。手术效果令人满意。
结论:
反求工程与选区激光烧结快速成型技术辅助完成颌面骨复杂骨折的坚固内固定,降低了手术难度,提高了手术的精度,缩短了手术时间,解决了在颌面骨复杂骨折治疗过程中骨折复位难,面形以及咬合功能恢复不理想,手术时间较长等问题,在颌骨复杂骨折整复中具有独特的优势,具有较好的应用前景。
1Object:
The purpose of this research is to study the precision of the selective laser singtering model, create a system technique for maxillofacial fracture and apply the technique for 2 patients to complete the method.
Material and method:
1. spiral CT scans to a dried cranial bone sample, thickness at 1.0mm intervals, were generated on spiral CT scanning system. Surface reconstruction was done for three images. The paper gives a method in which the filtration, binarization, bone’s contour extraction and vectorization is done orderly. And CT data was converted to STL format. The STL file was inputted into the rapid apparatus. The 3D stereo-temporal bone physical model was built layer by layer.
2. Head spiral CT scan was given to a patient who had maxillofacial fracture from an accident. The 3D stereo-temporal bone physical model was manufactured by selective laser singtering from the digitized data. To design of the operation, to prefabricate the titanium plate and to simulate the operation process. Then the operation was carried on patients by this. Evaluate the operation effect.
Result:
1. Physical model of the cranial bone was measured at x y z directions. The precision on the outline of the model was about 1mm, according to the dried cranial bone sample. But, the error was about 1.5mm on the thick and sharp parts. In this research, the experience and time consuming was lower than before.
2. The selective laser singtering system technique for maxillofacial fracture and apply the technique for patients to complete the method. This technique can recover the face form and function of the occlusion.
Conclusion:
The selective laser singtering system technique is helpful and useful in maxillofacial fracture. It may be widely used in future.
引文
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[16] Zein I,Hutmacher DW,Tan KC.,et al. Fused deposition modeling of novel scaffold architectures for tissueengineering application[J].Biomaterials,2002,23:1169～1185.
[17] Landers R,Hbner U,Schmelzeisen R,et al. Rapid prototyping of scaffolds derived from ther more versible hydrogels and tailored for applications in tissue engineering.Biomaterials,2002,23:4437～4447.
[18] Schantz JT, Hutmacher DW, Lam CX, Brinkmann M et al. Repair of calvarial defects with customised tissue-engineered bone grafts II. Evaluation of cellular efficiency and efficacy in vivo[J]. Tissue Eng, 2003,9(1):127-139.
[19] Tan KH, Chua CK, Leong KF, Naing MW, Cheah CM. Fabrication and characterization of three-dimensional poly(ether- ether- ketone)/-hydroxyapatite biocomposite scaffolds using laser sintering[J]. Proc Inst Mech Eng,2005,219(3):183-194.
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[2] Sun W, Lal P. Recent development on computer aided tissue engineering –a review. Computer Methods Programs Biomed, 2002, 67(2):85-103
[3] 肖 水 生 . 快 速 成 型 技 术 及 其 在 颅 颌 面 外 科 中 的 应 用 . 重 庆 医学,2002,31(12):1250-1251
[4] 程俊廷,张树林. 反求工程在快速成型中的应用. 精密制造与自动化, 2003, 153:20-22
[5] Ashly S. Rapid prototyping is coming of age. Mechanical Engineering, 1995, 117(7):63-68
[6] 郑卫国,颜永年.快速成型技术的原理、应用与发展.计算机辅助设计与制造,2001,06:3-5
[7] Adolenc I, Makeal. Rapid prototyping from a computer Scientist’s point of view. Rapid Prototyping journal,1996, 2(2):18～25
[8] Chua CK, The SH, Gay RKL. Rapid prototyping versus virtual prototyping in product design and manufacturing Int J Adv Manuf Technol, 1999,15:597-603
[9] Lindner A, Rasse M, Wolf HP, et al. Indications and use of stereolithographic skull reconstructions in maxillofacial surgery . Radiologe, 1995,35(9):578-582
[10] 赵万华,李涤尘,柯映林.光固化快速成形中树脂涂层技术研究.中国机破工程,1999,10(12):1333-1335
[11] 张人估,单忠德,隋光华.粉末材料的 SLS 工艺激光扫描过程研究.应用激光,1999, 19(5):299-301
[12] 吴 良 矿 , 颜 永 , 洪 国 栋 . 熔 融 挤 出 堆 积 成 形 系 统 精 度 分 析 . 中 国 机 械 工程,2000,8(5):465-468
[13] 李涤尘,李占利,赵万华.分层制造中几何失真性的数学原理与评价参数.中国机械工程,1999,8(5):52-53
[14] 张挽时,徐家兴.多层面螺旋 CT 和 CT 三维成像技术的临床应用.中国医学影像学杂志.2001,9(5):357-359
[15] 柳澄,秦维昌.多层螺旋 CT(一).医学影像学杂志.2000,10(3):194-195
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