Clinical application of individualized artifical mandible based on rapid prototyping technology

doi:10.3877/cma.j.issn.1674-1366.2011.02.009

Abstract

Abstract:

Objective

To evaluate the clinical results of individualized artifical titanium mandible produced by rapid prototyping （RP） and reverse engineering （RE） technology.

Methods

Six patients with mandiblar tumors and underwent surgery at the Department of Oral and Maxillofacial Surgery， People's Hospital of Zhongshan City， from 2005 to 2007 were selected.Measurement data of mandibular lesions were collected by CT scan and three-dimensional reconstruction.Bony lesions segments were removed in the digital model according to operation design.The mandibular defect models were made.Digital models of the implants were obtained by digital image technology.Resin models were obtained by rapid prototyping technique and used for casting of individual artifical mandible.

Results

The artifical mandibles produced by rapid prototyping fit in place quickly and accurately during surgery.All patients achieved one stage healing.After a follow-up of 7 to 30 months， mandibular defects were reconstructed satisfactorily and the mouth opening was 3.2 - 3.6 cm.The occlusions were normal.

Conclusions

RE/RP technology is feasible and accurate for reconstruction of discontinuous mandible.Individualized artifical mandible can fulfill the requirements of anatomy and function in mandible reconstruction.

Key words: Mandibular defect, Individual artifical mandible, Reverse engineering, Rapid prototyping

Ji-nan WU, Zhen-yu GONG, Jue-yao CHEN, Jun-lan CHEN, Qian WANG, Zhi-jie XU, Qiao-yi ZHENG, Ya-xiong LIU, Zhong-dong WANG. Clinical application of individualized artifical mandible based on rapid prototyping technology[J]. Chinese Journal of Stomatological Research(Electronic Edition), 2011, 5(02): 161-168.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhkqyxyjzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-1366.2011.02.009

https://zhkqyxyjzz.cma-cmc.com.cn/EN/Y2011/V5/I02/161

Figures/Tables 11

References 11

1	Yamashita Y， Yamaguchi Y， Tsuji M， et al.Mandibular reconstruction using autologous iliac bone and titanium mesh reinforced by laser welding for implant placement.Int J Oral Manxillofac Impants， 2008，23（6）：1143-1146.
2	Liu YX， Li DC， Lu BH， et al.The customized mandible substitute based on rapid prototyping.Rapid Prototyping J， 2003，9（3）：167-174.
3	Su R， Campbell GM， Boyd SK.Establishment of an architecture-specific experimental validation approach for finite element modeling of bone by rapid prototyping and high resolution computed tomograph.Med Eng Phys， 2007，29（4）：480-490.
4	龚振宇，刘彦普，周树夏，等.基于反求工程和快速原型的下颌骨缺损的修复.中华口腔医学杂志， 2004，39（1）：9-11.
5	李祖兵，赵怡芳，张文峰，等.下颌骨缺损即刻修复的临床研究.口腔医学纵横， 2001，17（4）：284-286.
6	Lee JH， Kim MJ， Choi WS， et al.Concomitant reconstruction of mandibular basal and alveolar bone with a free fibular flap.Int J Oral Maxillofac Surg， 2004，33（2）：150-156.
7	Rajon DA， Bova FJ， Bhasin RR， et al.An investigation of the potential of rapid prototyping technology for image guided surgery.J Appl Clin Med Phys， 2006，7（4）：81-98.
8	Leiggener C， Messo E， Thor A， et al.A selective laser sintering guide for transferring a virtual plan to real time surgery in composite mandibular reconstruction with free fibula osseous flaps.Int J Oral Maxillofac Surg， 2009，38（2）：187-192.
9	Cohen A， Laviv A， Berman P， et al.Mandibular reconstruction using stereolithographic 3-dimensional printing modeling technology.Oral Surg Oral Med Oral Pathol Oral Radiol Endod， 2009，108（5）：661-666.
10	颜功兴，张凯，冯小伟.CT 扫描和选区激光烧结技术在颌骨修复中的应用.激光杂志， 2009，30（4）：52-53.
11	Ng KW， Mauck RL， Statman LY， et al.Dynamic deformational loading results in selective application of mechanical stimulation in a layered， tissue-engineered cartilage construct.Biorheology， 2006，43（3-4）：497-507.

患者	性别	年龄（岁）	病理诊断	截骨范围	缺损类型	随访时间（月）
1	男	23	成釉细胞瘤	45至同侧升支（保留髁突）	B	30
2	女	38	骨纤维异常增殖	36至同侧升支（保留髁突）	B	7
3	女	22	成釉细胞瘤	44至对侧37（保留髁突）	BSSB	14
4	女	29	成釉细胞瘤	35至同侧升支（不保留髁突）	BRC	13
5	男	27	成釉细胞瘤	41至同侧升支（保留髁突）	RBS	15
6	女	49	成釉细胞瘤（复发）	44至对侧37（保留髁突）	BSSB	10

患者	性别	年龄（岁）	病理诊断	截骨范围	缺损类型	随访时间（月）
1	男	23	成釉细胞瘤	45至同侧升支（保留髁突）	B	30
2	女	38	骨纤维异常增殖	36至同侧升支（保留髁突）	B	7
3	女	22	成釉细胞瘤	44至对侧37（保留髁突）	BSSB	14
4	女	29	成釉细胞瘤	35至同侧升支（不保留髁突）	BRC	13
5	男	27	成釉细胞瘤	41至同侧升支（保留髁突）	RBS	15
6	女	49	成釉细胞瘤（复发）	44至对侧37（保留髁突）	BSSB	10

患者	缺损类型	随访时间（月）	满意度	张口度（cm）	咬合关系	材料暴露	评价	宿主反应
1	B	30	满意	3.6	正常	无	Ⅰ	无
2	B	7	中等	3.2	正常	无	Ⅰ	无
3	BSSB	14	满意	3.4	正常	无	Ⅰ	无
4	BRC	13	满意	3.2	正常	无	Ⅰ	无
5	RBS	15	满意	3.3	正常	无	Ⅰ	无
6	BSSB	10	满意	3.2	正常	无	Ⅰ	无

患者	缺损类型	随访时间（月）	满意度	张口度（cm）	咬合关系	材料暴露	评价	宿主反应
1	B	30	满意	3.6	正常	无	Ⅰ	无
2	B	7	中等	3.2	正常	无	Ⅰ	无
3	BSSB	14	满意	3.4	正常	无	Ⅰ	无
4	BRC	13	满意	3.2	正常	无	Ⅰ	无
5	RBS	15	满意	3.3	正常	无	Ⅰ	无
6	BSSB	10	满意	3.2	正常	无	Ⅰ	无

[1]	Hai-lin ZHANG, Yang WANG, Ming BAI, Ang ZENG, Ren-ju LI, Qun QIAO. Research on the application of reverse engineering technology in breast plastic surgery [J]. Chinese Journal of Breast Disease(Electronic Edition), 2011, 05(02): 127-135.
[2]	Junlan Chen, Jinan Wu, Wei Peng, Jueyao Chen, Qiaoyi Zheng. An experimental study of rabbit mandibular defect reconstruction with individualized prosthesis and tissue engineering [J]. Chinese Journal of Stomatological Research(Electronic Edition), 2019, 13(06): 328-335.
[3]	Yanna Zheng, Yujie Liang, Le Yang, Huanzi Lu, Guiqing Liao. The effect of speaking valve on functional restoration in tracheostomised patients after reconstruction of madibular defects based on the fluid dynamics analysis [J]. Chinese Journal of Stomatological Research(Electronic Edition), 2018, 12(04): 227-233.
[4]	Jianping Li, Xing Zhang, Wei Peng, Songling Chen. Individual computer-aided design templates for accurate reduction of unilateral zygomatic-orbital-maxillar complex bone fractures [J]. Chinese Journal of Stomatological Research(Electronic Edition), 2016, 10(06): 414-420.

Please choose a citation manager

Content to export