PDF(Pubmed)
Abstract：
The reconstruction of large mandibular defects is a challenge, and free vascularized bone flaps are most commonly used. However, the precision and symmetry of this repair are deficient, and patients have a risk of vascular embolism, flap necrosis, and donor site complications. Therefore, to explore an ideal alternative in mandibular reconstruction with high surgical accuracy and low complications is indispensable.
Seven patients with recurrent or large-scope ameloblastoma were enrolled in this study. All patients were provided with a fully digital treatment plan, including the design of osteotomy lines, surgical guides, and three-dimensional printed titanium mesh for implantation. With the assistance of surgical guide, ameloblastomas were resected, and custom 3D printed titanium mesh combined with posterior iliac bone harvest was used in mandibular reconstruction. A comparison was made between the discrepant surgical outcomes and the intended surgical plan, as well as the average three-dimensional deviation of the mandible before and after the surgery. At the same time, the resorption rate of the implanted bone was evaluated.
All patients completed the fully digital treatment process successfully without severe complications. Image fusion showed that the postoperative contour of the mandible was basically consistent with surgical planning, except for a slight increase in the inferior border of the affected side. The mean three-dimensional deviation of the mandible between the preoperative and postoperative periods was 0.78 ± 0.41 mm. The mean error between the intraoperative bone volume and the digital planning bone volume was 2.44%±2.10%. Furthermore, the bone resorption rates of the harvested graft 6 months later were 32.15%±6.95%.
The use of digital surgical planning and 3D-printed templates can assist surgeons in performing surgery precisely, and the 3D-printed titanium mesh implant can improve the patient\'s facial symmetry. 3D printed titanium mesh combined with posterior iliac cancellous bone graft can be regarded as an ideal alternative in extensive mandibular reconstruction.
Seven patients with recurrent or large-scope ameloblastoma were enrolled in this study. All patients were provided with a fully digital treatment plan, including the design of osteotomy lines, surgical guides, and three-dimensional printed titanium mesh for implantation. With the assistance of surgical guide, ameloblastomas were resected, and custom 3D printed titanium mesh combined with posterior iliac bone harvest was used in mandibular reconstruction. A comparison was made between the discrepant surgical outcomes and the intended surgical plan, as well as the average three-dimensional deviation of the mandible before and after the surgery. At the same time, the resorption rate of the implanted bone was evaluated.
All patients completed the fully digital treatment process successfully without severe complications. Image fusion showed that the postoperative contour of the mandible was basically consistent with surgical planning, except for a slight increase in the inferior border of the affected side. The mean three-dimensional deviation of the mandible between the preoperative and postoperative periods was 0.78 ± 0.41 mm. The mean error between the intraoperative bone volume and the digital planning bone volume was 2.44%±2.10%. Furthermore, the bone resorption rates of the harvested graft 6 months later were 32.15%±6.95%.
The use of digital surgical planning and 3D-printed templates can assist surgeons in performing surgery precisely, and the 3D-printed titanium mesh implant can improve the patient\'s facial symmetry. 3D printed titanium mesh combined with posterior iliac cancellous bone graft can be regarded as an ideal alternative in extensive mandibular reconstruction.
摘要：
背景：下颌骨大缺损的重建是一个挑战，最常用的是游离血管化骨瓣。然而,这种修复的精确性和对称性不足，患者有血管栓塞的风险，皮瓣坏死，和供体部位并发症。因此,探索一种手术精度高、并发症少的下颌骨重建的理想选择是必不可少的。
方法：本研究纳入7例复发或大范围成釉细胞瘤患者。所有患者均获得全数字化治疗方案,包括截骨线的设计，手术指南,和三维打印钛网植入。在手术指南的协助下，成釉细胞瘤被切除,定制3D打印钛网联合髂后骨收获用于下颌骨重建。在不同的手术结果和预期的手术计划之间进行了比较，以及手术前后下颌骨的平均三维偏差。同时,评估植入骨的吸收率。
结果：所有患者均顺利完成全数字化治疗过程，无严重并发症。图像融合显示下颌骨术后轮廓与手术计划基本一致,除了患侧的下边界略有增加。术前和术后期间下颌骨的平均三维偏差为0.78±0.41mm。术中骨量与数字计划骨量的平均误差为2.44%±2.10%。此外，6个月后收获的移植物的骨吸收率为32.15％±6.95％。
结论：使用数字手术计划和3D打印模板可以帮助外科医生精确地进行手术，3D打印的钛网植入物可以改善患者的面部对称性。3D打印钛网联合髂后松质骨移植可作为广泛下颌骨重建的理想选择。
方法：本研究纳入7例复发或大范围成釉细胞瘤患者。所有患者均获得全数字化治疗方案,包括截骨线的设计，手术指南,和三维打印钛网植入。在手术指南的协助下，成釉细胞瘤被切除,定制3D打印钛网联合髂后骨收获用于下颌骨重建。在不同的手术结果和预期的手术计划之间进行了比较，以及手术前后下颌骨的平均三维偏差。同时,评估植入骨的吸收率。
结果：所有患者均顺利完成全数字化治疗过程，无严重并发症。图像融合显示下颌骨术后轮廓与手术计划基本一致,除了患侧的下边界略有增加。术前和术后期间下颌骨的平均三维偏差为0.78±0.41mm。术中骨量与数字计划骨量的平均误差为2.44%±2.10%。此外，6个月后收获的移植物的骨吸收率为32.15％±6.95％。
结论：使用数字手术计划和3D打印模板可以帮助外科医生精确地进行手术，3D打印的钛网植入物可以改善患者的面部对称性。3D打印钛网联合髂后松质骨移植可作为广泛下颌骨重建的理想选择。
