3D打印改良牙支持式塞治器在下颌骨囊性病变开窗引流中的应用

doi:10.19439/j.sjos.2023.02.017

摘要/Abstract

摘要： 目的: 评价3D打印改良牙支持式囊肿塞治器在大型颌骨囊性病变开窗引流中的应用效果。方法: 选择2019年10月—2021年4月就诊于徐州市中心医院的下颌骨囊性病变患者40例,随机分为实验组（3D打印组）和对照组（传统塞治器组）,每组各20例。患者术前均行颌骨囊性病变数字化建模,获得病变囊腔容积数据,按计划设计开窗引流位点,并实施颌骨囊肿开窗引流手术。术后3天,实验组获取患者术后CBCT及Oral-scan数据,设计多孔柱道数字化改良牙支持式塞治器,选择钛合金材质3D打印后使用。对照组由有经验的医师手工取模,制作树脂卡环式塞治器。比较2组在模型制取过程中的疼痛视觉模拟评分（visual analogue scale, VAS）、塞治器固位性能、机械性能及对基牙影响的差异,以及术后1、3、6个月时囊腔体积变化。采用SPSS 25.0软件包对数据进行统计学分析。结果: 实验组数字化印模制备钛合金为打印材料的囊肿塞治器患者主诉舒适度较对照组高,囊肿塞治器的机械强度、稳定性较对照组更好（P<0.05）;固位力方面2组无显著差异（P>0.05）。实验组术后3个月和6个月的囊腔骨性体积缩小率显著高于传统塞治器组（P<0.05）。结论: 数字化3D打印改良牙支持式钛合金塞治器具有良好的机械性能和稳定性,对基牙损伤小,不产生侧向力,具有精准化、个性化及舒适化优势。改良冲洗柱道使囊腔充分立体化冲洗,加快囊腔缩小速率,缩短患者二次手术前等待时间,值得临床推广。

关键词: 颌骨囊性病变, 开窗引流, 囊肿塞, 3D打印

Abstract: PURPOSE: To evaluate the application value of 3D printing modified dental support cyst plug in fenestration of large jaw cystic lesions. METHODS: Forty patients with mandibular cystic disease in Xuzhou Central Hospital from October 2019 to April 2021 were selected. They were randomly divided into experimental group(3D printing group) and control group (traditional plug group), with 20 cases in each group. All enrolled patients underwent preoperative digital modeling of cystic lesions of the jaw, obtained the cystic cavity volume data of preoperative lesions, designed the windowing site according to the plan and performed decompression for jaw cysts. Three days after surgery, the patient's postoperative CBCT and Oral-scan data in the experimental group was obtained, and a digitally modified tooth-supported cyst plug with porous column channel was designed, and titanium alloy material for 3D printing was selected. In the control group, the plug was manually molded by experienced physicians. The visual analogue scale(VAS) score of pain, retention, mechanical properties of the plug and its effect on the adjacent teeth were compared between the two groups during the process of model preparation, and the changes of the cyst volume 1, 3 and 6 months after operation were compared between the two groups. SPSS 25.0 software package was used for data analysis. RESULTS: Compared with the control group, the patients in the experimental group who made titanium alloy as printing material by digital impression complained more comfortable, and the mechanical strength and stability of the cyst plug were better than those in the control group(P< 0.05). There was no significant difference in retention between the two groups(P>0.05). The reduction rate of cyst volume in the experimental group was significantly higher than that in the traditional plug group 3 and 6 months after operation(P<0.05). CONCLUSIONS: The modified tooth-supported titanium alloy cyst plug with digital 3D printing has good mechanical properties and stability. It has little damage to the abutment and no lateral force, and has the advantages of precision, individualization and comfort. The improved irrigation and injection channel can fully flush the cavity and speed up the narrowing of the cyst and reduce the waiting time before the second operation, which is worth promoting in clinical practice.

Key words: Cystic lesions of the jaw, Decompression, Cyst plug, 3D printing

中图分类号:

R739.8

寇鹏, 李迎梅, 李志萍, 孟箭. 3D打印改良牙支持式塞治器在下颌骨囊性病变开窗引流中的应用[J]. 上海口腔医学, 2023, 32(2): 203-208.

KOU Peng, LI Ying-mei, LI Zhi-ping, MENG Jian. Application of 3D printing modified tooth-supported cyst plug in decompression of mandibular cystic lesions[J]. Shanghai Journal of Stomatology, 2023, 32(2): 203-208.

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