口腔疾病防治 ›› 2017, Vol. 25 ›› Issue (9): 545-553.DOI: 10.12016/j.issn.2096-1456.2017.09.001

• 专家论坛 •    下一篇

数字化外科技术在下颌骨缺损重建中的应用

彭歆, 章文博   

  1. 北京大学口腔医院口腔颌面外科,北京(100081)
  • 收稿日期:2017-04-30 修回日期:2017-05-22 出版日期:2017-09-20 发布日期:2018-09-03
  • 作者简介:

    【作者简介】 彭歆,北京大学口腔医学院口腔颌面外科教授、主任医师、博士研究生导师,口腔颌面外科副主任。现任中华口腔医学会口腔颌面外科专业委员会委员、中华口腔医学会口腔医学计算机专业委员会委员、中国抗癌协会头颈肿瘤专业委员会委员、中华医学会显微外科学分会青年委员、国际内固定学会颅颌面分会亚太理事会理事及中国区主席、亚太重建显微外科联盟中国部委员、卫生部医学考试中心专家委员会委员。主要专业领域为口腔颌面部肿瘤和缺损修复重建、涎腺疾病。目前已发表论文170余篇,主持国家及省部级科研项目4项,获国家和省部级科技进步奖6项。

  • 基金资助:
    科技部支撑计划项目(2014BAI04B06);北京市科委首都市民健康培育项目(Z161100000116053)

Application of digital surgical techniques in mandibular reconstruction

Xin PENG, Wenbo ZHANG   

  1. Department of Oral And Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing 100081, China
  • Received:2017-04-30 Revised:2017-05-22 Online:2017-09-20 Published:2018-09-03

摘要:

下颌骨是面下1/3主要的骨性支架,由于肿瘤切除、炎症及外伤等原因导致的下颌骨缺损,严重影响患者的外形与功能。以腓骨瓣为代表的血管化游离骨组织瓣是目前修复下颌骨缺损的主要方法。传统的下颌骨重建手术,主要依赖术者经验进行,缺乏个性化的术前设计与精确的术中引导,难以达到精确重建的目标。近年来,虚拟设计、快速成型、手术导航等数字化技术已广泛应用于下颌骨缺损的重建手术中:术前在数字化软件中对下颌骨肿瘤的切除及下颌骨缺损的重建手术进行精确的个性化设计;术中使用手术导板或手术导航技术辅助将术前设计转化为现实。许多研究结果表明,应用数字化外科技术,可显著提高下颌骨缺损重建的临床治疗效果。本文将结合近年来国内外文献报道及作者课题组临床实践经验,对数字化外科技术在下颌骨缺损重建中的应用进行归纳与总结。

关键词: 下颌骨缺损, 修复重建, 数字化外科技术, 血管化骨组织瓣, 手术导航

Abstract:

The mandible is the most important bony support in the lower 1/3 skeleton of the face which is critical for both esthetics and function. Mandibular defects, resulting from tumor resection, can cause severe functional and cosmetic deformities. Nowadays, vascularized bony tissue transfer such as free fibula flap has been widely used for mandibular reconstruction. However, traditional mandibular reconstruction based on clinical experience may hawe some problems in accuracy and efficiency because of lacking individualized design. In recent years, digital surgical techniques such as computer-aided design, rapid prototyping and surgical navigation have been used for mandibular reconstruction surgery. Accurate design for tumor resection as well as individualized design for mandibular reconstruction can be performed with computer preoperatively which help to turn the virtual plan into reality by using surgical guide or navigation. Many studies suggested that digital surgical techniques could significantly improve the clinical outcome of mandibular reconstruction. In this article, we summarized the application of digital surgical techniques for mandibular reconstruction based on our own experience and literatures review.

Key words: Mandibular defect, Reconstruction, Digital surgical techniques, Vascularized bony tissue flap, Surgical navigation

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