高仿真牙颅颌模型外科技术辅助手术优先矫正颌面部不对称畸形

目的：探讨快速原型技术制作的高仿真牙颅颌模型与牙弓石膏模型精确结合用于手术优先指导矫正颌面部不对称畸形的可行性。方法：5例颌面部不对称畸形患者均进行全头颅三维螺旋CT扫描，将数据输入快速原型机，制作三维打印头颅模型，然后将牙弓石膏模型按等比例替换三维打印模型的牙弓，以组成高仿真牙颅颌模型复合体。利用该复合体进行术前模拟截骨，评价截骨位置及截骨量，评估患者颏部的对称性以及颞下颌关节的改变，术后 6 个月评估手术效果。结果：5 例患者术前建立高仿真牙颅颌模型复合体，很好地预测了手术效果。术后随访半年，患者对外形感到满意，无颞下颌关节紊乱综合征（TMD）等并发症。结论：高仿真牙颅颌模型复合体更好地预测偏颌畸形患者术后颏部及髁突的改变，为该类患者的“手术优先”治疗模式提供了有益的参考。

Application of rapid prototyping technology and high simulation dental craniofacial model surgery in surgery-first-orthodontic-approach of maxillofacial asymmetry

PURPOSE: Rapid prototyping(RP) technology was employed to make high quality 3-dimensional head simulator, which was then precisely combined with a fine plaster cast of dental arch by facebow for model surgery to guide surgery-first-orthodontic-approach for maxillofacial asymmetry and evaluate the effect. METHODS: Five patients with dento-maxillofacial deformities underwent spiral CT scan to collect raw data, which were then inputted into rapid prototyping machine to generate 3-dimensional head-simulators. The plaster casts of dental arch were subsequently replaced with those of 3-dimensional head-simulators in the same ratio. Finally, high simulation dental craniofacial models were formed for simulating osteotomy prior to surgery, in order to assess the position and volume of osteotomy, the symmetry of chin and variation of temporomandibular joint (TMJ), and surgical effect 6 months after operation. RESULTS: High simulation dental craniofacial models from 5 patients were shown to be good for predicting the effect of surgery. The 6-month follow-up results showed the patients were satisfied with their appearances without complications including TMJ disorder. CONCLUSIONS: High simulation dental craniofacial model is valuable in precisely simulating osteotomy, contributing to understand surgery-first-orthodontic-approach for maxillofacial asymmetrical patients.