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Abstract：
This systematic review was aimed at gathering the clinical and technical applications of CAD/CAM technology for craniofacial implant placement and processing of auricular prostheses based on clinical cases. According to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, an electronic data search was performed. Human clinical studies utilizing digital planning, designing, and printing systems for craniofacial implant placement and processing of auricular prostheses for prosthetic rehabilitation of auricular defects were included. Following a data search, a total of 36 clinical human studies were included, which were digitally planned and executed through various virtual software to rehabilitate auricular defects. Preoperative data were collected mainly through computed tomography scans (CT scans) (55 cases); meanwhile, the most common laser scanners were the 3dMDface System (3dMD LLC, Atlanta, Georgia, USA) (6 cases) and the 3 Shape scanner (3 Shape, Copenhagen, Denmark) (6 cases). The most common digital design software are Mimics Software (Mimics Innovation Suite, Materialize, Leuven, Belgium) (18 cases), Freeform software (Freeform, NC, USA) (13 cases), and 3 Shape software (3 Shape, Copenhagen, Denmark) (12 cases). Surgical templates were designed and utilized in 35 cases to place 88 craniofacial implants in auricular defect areas. The most common craniofacial implants were Vistafix craniofacial implants (Entific Medical Systems, Goteborg, Sweden) in 22 cases. A surgical navigation system was used to place 20 craniofacial implants in the mastoid bone. Digital applications of CAD/CAM technology include, but are not limited to, study models, mirrored replicas of intact ears, molds, retentive attachments, customized implants, substructures, and silicone prostheses. The included studies demonstrated a predictable clinical outcome, reduced the patient\'s visits, and completed the prosthetic rehabilitation in reasonable time and at reasonable cost. However, equipment costs and trained technical staff were highlighted as possible limitations to the use of CAD/CAM systems.
摘要：
本系统综述旨在根据临床案例收集CAD/CAM技术在颅面假体放置和加工中的临床和技术应用。根据系统评价和荟萃分析(PRISMA)指南的首选报告项目，进行了电子数据搜索。利用数字规划的人体临床研究，设计,包括用于颅面植入物放置的打印系统和用于修复耳廓缺损的耳廓假体的加工。在数据搜索之后，共纳入36项人体临床研究，通过各种虚拟软件进行数字计划和执行，以修复耳廓缺陷。术前资料主要通过计算机断层扫描(CT扫描)收集(55例);同时,最常见的激光扫描仪是3dMDface系统(3dMDLLC，亚特兰大,格鲁吉亚,美国）（6例）和3形状扫描仪（3形状，哥本哈根,丹麦）（6例）。最常见的数字设计软件是Mimics软件（MimicsInnovationSuite，物化,鲁汶,比利时）（18例），Freeform软件(Freeform,NC,美国）（13例），和3个形状软件(3个形状，哥本哈根,丹麦)(12例)。在35例病例中设计并使用了手术模板，在耳廓缺损区域放置了88个颅面植入物。最常见的颅面植入物是Vistafix颅面植入物(完整的医疗系统，哥德堡,瑞典）22例。使用手术导航系统将20个颅面植入物放置在乳突骨中。CAD/CAM技术的数字化应用包括,但不限于,研究模型，完整耳朵的镜像复制品，模具，保留附件，定制植入物,子结构，和硅胶假体。纳入的研究证明了可预测的临床结果，减少了患者的就诊次数，并在合理的时间和合理的成本下完成了假肢康复。然而,设备成本和训练有素的技术人员被强调为使用CAD/CAM系统的可能限制。
