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目的:通过对正常下颌骨形态的三维测量与分析,确定下颌骨塑形参数,指导腓骨塑形板的试制与应用。方法:收集55例华东地区正常下颌骨CT数据(Dicom格式),应用自编颌骨手术规划软件行下颌骨计算机建模、标志点设定(7个标志点)以及外形变量测定(共14个线性和角度变量)。采用SAS8.0软件包对数据进行t检验和glm方差分析,确定下颌骨塑形参数并指导腓骨塑形板的设计与试制。应用腓骨塑形板为1例二期下颌骨(角-角)缺损患者行移植腓骨的快速塑形。结果:不同性别、个体下颌骨外形的差异主要在于结构的长短(P<0.05),而非曲度的大小(P>0.05),且下颌骨前份(颏部)外形变异相对小于后份(下颌支、下颌体)。确定下颌骨塑形参数为下颌体角140°、下颌颏角120°、下颌颏长30mm。临床应用腓骨塑形板成功为1例下颌骨(角-角)缺损患者实施移植腓骨的快速塑形,获得满意效果。结论:腓骨塑形板能够快速且较为准确地实现移植腓骨的“四段式”塑形。
OBJECTIVE: To determine the shape parameters of the mandible and to guide the trial manufacture and application of the fibular shape plate through three-dimensional measurement and analysis of the normal mandible shape. Methods: 55 cases of normal mandibular CT data (Dicom format) were collected from 55 patients in East China. The mandible was modeled by computer software of self-designed jaw surgery program. Marker points (7 markers) and shape variables were measured Linear and angular variables). SAS8.0 software package for t-test data and glm analysis of variance to determine the mandibular shaping parameters and to guide the design and trial of the fibular shaping plate. Fibular plastic plate was used as one of the two cases of mandibular (angle - angle) defects in patients with rapid fibular grafting. Results: The difference of mandible shape in different genders and individuals was mainly due to the length of the structure (P <0.05) but not to the size of curvature (P> 0.05) Mandibular branch, mandibular body). Determine the mandibular shaping parameters of mandibular body angle of 140 °, mandibular chin angle 120 °, mandibular chin length 30mm. The successful application of fibular plastic plate in clinical treatment of 1 case of mandibular (angle - angle) defects in the rapid implementation of graft fibula graft, with satisfactory results. Conclusion: The fibular plastic plate can quickly and accurately achieve the “four-stage” plastic grafting of the fibula.