PDF(Pubmed)
Abstract：
BACKGROUND: Solitary Bone Cyst (SBC), also known as a simple bone cyst, hemorrhagic cyst, or traumatic cyst is classified by the WHO among non-odontogenic benign lesions of the jaw. The article explores the use of a static 3D-printed surgical guide to treat mandibular SBC, emphasizing a minimally surgical approach for this lesion.
METHODS: A 20-year-old woman was referred for a persistent mandibular SBC lacuna, without specific complaints. Her medical history included a previous bone trepanation for a SBC in the same area, radiologically and surgically confirmed. X-ray assessment showed a well-defined unilocular radiolucency surrounding the root of the first left lower molar (tooth #36), measuring 10 × 10 mm. Pulp sensitivity was normal. CBCT data and STL files of dental cast were obtained preoperatively and registered. A 3D-printed surgical guide was used for minimally invasive trepanation of the buccal cortical. The simulation used a targeted endodontic microsurgery approach in order to determine axis and diameter of the trephine. Surgery was performed under local anesthesia. The guide was tooth supported integrating tubes and a fork for guiding precise trepanation. A 3.5 mm round bone window was created, leaving an empty cavity confirming SBC diagnosis and permitting bone curettage. A blood clot was obtained to promote bone healing. Complete reossification was observed after 6 months. The follow-up at 2 years confirmed a complete bone healing with normal pulp sensitivity.
CONCLUSIONS: The 3D-printed windowed surgical guide with dental support offers big advantages, including improved visibility and reduced errors. Compared to traditional guides, it eliminates visual hindrance and allows easier and quick access to confined areas as well as an improved irrigation during drilling process. The article also highlights the importance of preoperative planning while acknowledging potential limitations and errors and surgical complications.
CONCLUSIONS: The use of the 3D-printed surgical guide could be used in routine for minimally invasive intervention of SBC. This case also demonstrates the potential utility of this approach in various procedures in oral and maxillofacial surgery. The technique provides precise localization, reducing complications and enhances operative efficiency.
METHODS: A 20-year-old woman was referred for a persistent mandibular SBC lacuna, without specific complaints. Her medical history included a previous bone trepanation for a SBC in the same area, radiologically and surgically confirmed. X-ray assessment showed a well-defined unilocular radiolucency surrounding the root of the first left lower molar (tooth #36), measuring 10 × 10 mm. Pulp sensitivity was normal. CBCT data and STL files of dental cast were obtained preoperatively and registered. A 3D-printed surgical guide was used for minimally invasive trepanation of the buccal cortical. The simulation used a targeted endodontic microsurgery approach in order to determine axis and diameter of the trephine. Surgery was performed under local anesthesia. The guide was tooth supported integrating tubes and a fork for guiding precise trepanation. A 3.5 mm round bone window was created, leaving an empty cavity confirming SBC diagnosis and permitting bone curettage. A blood clot was obtained to promote bone healing. Complete reossification was observed after 6 months. The follow-up at 2 years confirmed a complete bone healing with normal pulp sensitivity.
CONCLUSIONS: The 3D-printed windowed surgical guide with dental support offers big advantages, including improved visibility and reduced errors. Compared to traditional guides, it eliminates visual hindrance and allows easier and quick access to confined areas as well as an improved irrigation during drilling process. The article also highlights the importance of preoperative planning while acknowledging potential limitations and errors and surgical complications.
CONCLUSIONS: The use of the 3D-printed surgical guide could be used in routine for minimally invasive intervention of SBC. This case also demonstrates the potential utility of this approach in various procedures in oral and maxillofacial surgery. The technique provides precise localization, reducing complications and enhances operative efficiency.
摘要：
背景：孤立性骨囊肿（SBC），也被称为简单的骨囊肿，出血性囊肿,或创伤性囊肿被WHO归类为非牙源性颌骨良性病变。本文探讨了使用静态3D打印手术指南治疗下颌SBC，强调这种病变的最小手术方法。
方法：一名20岁女性因持续下颌SBC腔隙转诊，没有具体的投诉。她的病史包括先前在同一地区的SBC骨钻孔，放射学和手术证实。X线评估显示，第一颗左下磨牙（36号牙齿）的根部周围有明确的单眼射线不透性，测量10×10毫米。纸浆敏感性正常。术前获得并登记了牙模的CBCT数据和STL文件。3D打印的手术指南用于颊皮质的微创钻孔。模拟使用靶向牙髓显微手术方法来确定环钻的轴和直径。手术在局部麻醉下进行。导向器由牙齿支撑，集成管和叉子用于引导精确的钻孔。创建了一个3.5毫米的圆形骨窗，留下空洞，确认SBC诊断并允许刮骨。获得血凝块以促进骨愈合。6个月后观察到完全再骨化。2年的随访证实骨完全愈合，牙髓敏感性正常。
结论：带有牙科支撑的3D打印窗口化手术指南具有很大的优势，包括改进的可见性和减少的错误。与传统导游相比，它消除了视觉障碍，并允许更容易和快速地进入密闭区域，以及在钻井过程中改善灌溉。本文还强调了术前计划的重要性，同时认识到潜在的局限性，错误和手术并发症。
结论：3D打印手术指南的使用可用于常规的SBC微创干预。此案例还证明了这种方法在口腔颌面外科手术中的各种程序中的潜在实用性。该技术提供了精确的定位，减少并发症，提高手术效率。
方法：一名20岁女性因持续下颌SBC腔隙转诊，没有具体的投诉。她的病史包括先前在同一地区的SBC骨钻孔，放射学和手术证实。X线评估显示，第一颗左下磨牙（36号牙齿）的根部周围有明确的单眼射线不透性，测量10×10毫米。纸浆敏感性正常。术前获得并登记了牙模的CBCT数据和STL文件。3D打印的手术指南用于颊皮质的微创钻孔。模拟使用靶向牙髓显微手术方法来确定环钻的轴和直径。手术在局部麻醉下进行。导向器由牙齿支撑，集成管和叉子用于引导精确的钻孔。创建了一个3.5毫米的圆形骨窗，留下空洞，确认SBC诊断并允许刮骨。获得血凝块以促进骨愈合。6个月后观察到完全再骨化。2年的随访证实骨完全愈合，牙髓敏感性正常。
结论：带有牙科支撑的3D打印窗口化手术指南具有很大的优势，包括改进的可见性和减少的错误。与传统导游相比，它消除了视觉障碍，并允许更容易和快速地进入密闭区域，以及在钻井过程中改善灌溉。本文还强调了术前计划的重要性，同时认识到潜在的局限性，错误和手术并发症。
结论：3D打印手术指南的使用可用于常规的SBC微创干预。此案例还证明了这种方法在口腔颌面外科手术中的各种程序中的潜在实用性。该技术提供了精确的定位，减少并发症，提高手术效率。
