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背景:偏颌畸形涉及到的解剖部位较多,修复较复杂,同时由于此类疾病的治疗方法没有标准化的手术模式,患者的畸形类型也有很大差别,所以此类手术的设计和实施主要依靠医生的经验,会有许多不尽人意之处。目的:探讨利用数字外科技术制作仿真头颅模型,用来辅助手术设计和矫正偏颌畸形的方法。方法:针对1例上、下颌骨外伤性偏颌畸形患者,采用CT扫描和三维重建,应用快速成型技术,制作患者颅面部骨组织三维模型,在此模型上设计手术方案。为保持目前咬合关系,将上颌骨下份和下颌骨整体逆时针旋转5°,左侧下颌支去除部分骨质,将颏部左移至中线。模拟手术过程:在三维头颅模型上进行截骨、移位等操作,观察矫治效果。在三维头颅模型上制作必要的辅助工具,用来指导手术并提高矫治的精确性。结果与结论:患者矫治后对面部外形效果满意,咬合关系、咀嚼功能均未受到影响。提示数字外科技术能真实再现畸形颌骨的形态,为准确诊断、设计矫治方案、模拟矫治过程、指导手术进行提供理想的外科模型,对偏颌畸形的矫正有很好的辅助作用。
BACKGROUND: Orthognathic malformations involve more anatomical parts and repair more complicated. Because the treatment methods for such diseases do not have a standardized surgical model and the patient’s deformity types are also very different, so the design and implementation of such surgery rely mainly on Doctor’s experience, there will be many unsatisfactory. OBJECTIVE: To explore a method of using digital surgery to make a simulated craniofacial model to assist in surgical design and correction of the maxillary deformity. Methods: One case of mandibular traumatic maxillary deformity was made by CT scan and three-dimensional reconstruction. The three-dimensional model of craniofacial bone was made by rapid prototyping technique. The surgical design was designed on this model. In order to maintain the current occlusion, the lower maxilla and the mandible were rotated counterclockwise by 5 °. The left mandibular branch removed part of the bone and left the chin to the midline. Simulate the surgical process: osteotomy, displacement and other operations on the three-dimensional skull model to observe the effect of correction. In the three-dimensional model of the skull to make necessary aids to guide the operation and improve the accuracy of orthodontic treatment. RESULTS AND CONCLUSION: After correction, the facial appearance was satisfactory, the occlusal relationship and masticatory function were not affected. It is suggested that digital surgical technique can truly represent the morphology of deformity jaw. It provides an ideal surgical model for accurate diagnosis, design of orthodontic treatment, simulation of the treatment process and guidance of the operation, which is helpful to correction of orthognathic jaw deformity.