金属三维打印技术在导航辅助个体化定制下颌骨牵引成骨术中的应用基础研究

Compare to the triditional mandibular distraction osteogenesis, customize-made distraction device and individualized treatment planning is more efficient for specific clinical cases with complex mandibular deformities and defects. It may reduce the treatment time and incidence of surgical complications. However, the regular distraction devices and planning software could not provide a computer aided customize made mandibular distraction. Currently, based on the 3D printing system, a cusomized diatraction was designed and manufactured. It may reduce the total cost and increase the medical treament outcome. In this project, a three dimensional printing system was introduced, which the material were titanium powder. Combined with electron beam melting 3D printing technique and surgical navigation syatem, a customize made mandibular distraction devices could be planned and manufactured. The continued mandibular reconstruction with systematic continuing research work was based on 3D printing conception. By using 3D printing system combined with surgical navigation technique, a customize made mandibular distratoin devices could be transferred into real time surgery with high accuracy. A serial experiments will be carried out for testing the accuracy and reproducibilities of this technique.

对于复杂的下颌骨畸形和缺损病例，个体化治疗方案与定制的牵引器更符合不同病情的治疗需求，相比于传统方法，能更有效地矫正畸形与修复缺损，减少了手术次数并降低了并发症的发生，有利于提高了疗效。但受限于常规成品牵引器的限制和手术规划与实时操作过程中的不确定性，目前个体化牵引成骨术的应用非常有限。本研究基于前期研究成果，依据电子束熔融成型三维制造技术与导航外科理念，通过计算机辅助设计定制了适合不同下颌骨畸形与缺损的牵引器，应用先进的三维打印技术进行工业制造，并通过一系列实验和测试来验证个体化定制牵引器的精度和可行性。同时借助有自主知识产权的计算机立体定向的导航外科系统平台，将定制牵引器与导航外科技术相结合，准确地将术前规划通过实时导航转移到手术操作过程中，建立专门的术前规划与手术操作方法，并通过一系列模拟手术与动物实验来检验该方法的可行性与精度，目前尚未见相关报道。

牵引成骨作为一种简单有效的新技术，可以有效延长并新生骨骼，在颌骨畸形和缺损修复中起着重要的作用。但临床上受限于常规成品牵引器的限制，以及手术规划与实时操作过程中的误差，使得此技术在口腔颌面临床诊疗中的应用有所限制。本项目基于前期研究成果，依托三维制造技术与导航外科理念，通过计算机辅助设计定制了适合不同颌骨畸形与缺损的牵引器，应用先进的三维打印技术进行工业制造，通过测试验证了该定制牵引器的力学性能、制作精度和手术操作的可行性。同时借助拥有自主知识产权的计算机立体定向的导航外科系统平台，将定制牵引器与导航外科技术相结合，可准确地将术前规划通过实时导航转移到手术操作过程中，并建立了专门的牵引成骨手术规划与操作流程，通过模拟手术与动物实验检验了该方法的可行性与精度，发表论文7 篇，获得专利授权8 项，参加国内会议交流3 次，参加国际会议交流3次。本项目的研究结果为临床棘手的复杂颌骨畸形和缺损病例，提供了个体化治疗方案，三维金属打印定制的牵引器更符合不同病情的治疗需求，导航外科技术精准定位，两者叠加极为有效的提高了颌面部畸形精准治疗的总体疗效。