METHODS: Patients post-mandible resection with CAD-planned DCIA flap reconstruction were evaluated. Postoperative radiograph-derived 3D models were aligned with 3D models from the CAD plans for osteotomy position, angle, and flap volume comparison. To evaluate the DCIA flap\'s suitability for prosthetic dental rehabilitation, a plane was created in the support zone and crestal in the middle of the DCIA flap. The lower jaw was rotated to close the mouth and the distance between the two planes was measured.
RESULTS: 20 patients (12 males, 8 females) were included. Mean defect size was 73.28 ± 4.87 mm; 11 L defects, 9 LC defects. Planned vs. actual DCIA transplant volume difference was 3.814 ± 3.856 cm³ (p = 0.2223). The deviation from the planned angle was significantly larger at the dorsal osteotomy than at the ventral (p = 0.035). Linear differences between the planned DCIA transplant and the actual DCIA transplant were 1.294 ± 1.197 mm for the ventral osteotomy and 2.680 ± 3.449 mm for the dorsal (p = 0.1078). The difference between the dental axis and the middle of the DCIA transplant ranged from 0.2 mm to 14.8 mm. The mean lateral difference was 2.695 ± 3.667 mm in the region of the first premolar.
CONCLUSIONS: The CAD-planned DCIA flap is a solution for reconstructing the mandible. CAD planning results in an accurate reconstruction enabling dental implant placement and dental prosthetics.
方法:对CAD计划的DCIA皮瓣重建的下颌骨切除术后患者进行评估。术后X线片衍生的3D模型与CAD截骨位置计划中的3D模型对齐,angle,和皮瓣体积比较。为了评估DCIA皮瓣对假牙修复的适用性,在支撑区创建了一架飞机,并在DCIA皮瓣的中部创建了一架飞机。旋转下颌以闭合嘴,并测量两个平面之间的距离。
结果:20例患者(12例男性,包括8名女性)。平均缺陷尺寸为73.28±4.87mm;11L缺陷,9个LC缺陷。计划与实际DCIA移植体积差为3.814±3.856cm²(p=0.2223).背侧截骨术与计划角度的偏差明显大于腹侧(p=0.035)。腹侧截骨术计划的DCIA移植与实际的DCIA移植之间的线性差异为1.294±1.197mm,背侧为2.680±3.449mm(p=0.1078)。牙轴与DCIA移植中部之间的差异范围为0.2mm至14.8mm。第一前磨牙区域的平均横向差为2.695±3.667mm。
结论:CAD计划的DCIA皮瓣是重建下颌骨的解决方案。CAD计划可实现精确的重建,从而实现牙科植入物的放置和牙科修复。