Abstract:

Objective To explore the application value of digital 3D printing technology for repairing mandibular defects with fibular flaps and to provide a basis for accurate repair mandibular defects.Methods Nine cases of mandibular defects were selected, and spiral CT and CTA of the lower limbs were performed before the operation. The osteotomy guide plate and plastic guide plate were created using computer software, and the titanium plate was rebuilt according to the printed mandibular model. During the operation, an osteotomy guide plate was used for mandibular resection; a fibula bone plastic guide plate was used to reconstruct the fibular flap and reconstruct the mandibular defects.Results The entire fibula flap survived, and the occlusal relationship was good. There was no complications in the donor site. The patients were satisfied with the appearance of the repair. All patients were followed up for 3 to 6 months, at which point the bone was basically healed.Conclusion Using a digital 3D printing technique to repair mandible defects with a fibular flap can shorten the operation time, reduce the risks of operation, and better restore the maxillofacial shape and the function of the jaw, which is consistent with the concept of appropriate medical treatment. Additionally, this process provides a better method for the treatment of mandibular defects.

Key words: Digital technology, Three-dimensional printing, Mandibular defect, Guide plate, Fibular flap, Jaw reconstruction

摘要：

目的 探讨数字化3D打印技术在腓骨肌皮瓣修复下颌骨缺损中的应用价值,为精准修复下颌骨缺损提供依据。方法 选择9例下颌骨肿瘤或肿瘤术后缺损病例,完善颌骨螺旋CT和下肢CT血管造影（CT-angiography,CTA）检查,然后利用获得的数据在电脑软件上制作截骨导板和塑形导板,并且根据打印的下颌骨实体模型预弯制重建钛板。在手术中根据截骨导板、腓骨取骨及塑形导板,完成下颌骨切除,腓骨肌皮瓣的制备塑形及下颌骨缺损的修复等。结果 所有病例的腓骨肌皮瓣均成活,咬合关系基本正常;供区无并发症;患者自觉外形恢复满意;3~6个月复查,腓骨与下颌骨基本愈合。结论 将数字化3D打印技术用于腓骨肌皮瓣修复下颌骨缺损,能较好地恢复颌面外形及咬合关系。

关键词: 数字化技术, 3D打印, 下颌骨缺损, 导板, 腓骨肌皮瓣, 颌骨重建