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Objective@#The study presents a new method to prefabricate the nasoalveolar molding appliances for preoperative cleft lip and palate by using three-dimensional technology.@*Methods@#A long term retrospective study of 40 cases of infants with unilateral cleft lip and palate who underwent the preoperative 3D models of alveolar bone acquisition, computer aided design for the rapid prototyping process, gypsum powder printing maxillary three-dimensional entity model and install the appliance for 3-4 months (or alveolar cleft<2 mm). Simultaneously, primary rhinoplasty can be done during cleft lip repair. All patients had clinic visits three times each month.@*Results@#Deformities of infants who underwent this treatment, were significantly improved. The alveolar cleft was significantly reduced (P<0.01), while bilateral alveolar tissue volume was significantly increased (P<0.01). Alveolar bone morphology was more symmetrical than before.@*Conclusions@#The digital design and manufacture system of appliances for preoperative cleft lip and palate can be successfully applied to the preoperative orthodontic treatment. The sequence treatment of cleft lip and palate becomes better improved. It can shorten the time duration and the numbers of clinic visit on the basis of ensuring the accuracy of preoperative orthodontic effect.
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Objective To investigate the value of computer aided design and 3D printing model in operation for complex mandibular fractures.Methods The clinical data of 136 patients with complex mandibular fractures treated from June 2006 to June 2016 were retrospectively analyzed.The patients were divided into 3D group (n =28) and conventional group (n =108) based on the use of computer aided design and 3D printing model.There were 24 males and four females in 3D group,with the age of (33.8 ± 15.4) years.There were 91 males and 17 females in conventional group,with the age of (30.3± 11.9)years.The 3D group used computer aided design and 3D printing model to develop the surgical plan,and the conventional group used traditional CT scan image data.The operation time,intraoperative blood loss,incidence of postoperative adverse events,and the distance differences between the ipsilateral and the five contralateral maxillofacial markers were compared between the two groups (△L1:the difference between the mandibular angle point and the condyle apex;△L2:the difference between the mandibular angle point and the chin vertex;△L3:the difference between the apex of the chin and the apical point;△L4:the difference between the inner mandibular angle point and the Inferior alveolar margin point;△L5:the distance between the inner mandibular angle and the sagittal plane).Results The operation time in the 3D group and the conventional group were 155 (126.25,183.75)min and 235 (156.25,268.75)min,respectively.The intraoperative blood loss in the 3D group and the conventional group were 100 (50.0,187.5) ml and 125 (100.0,200.0) ml,respectively.In the 3D group,one patient had mild occlusion disorder.In the conventional group,4 patients had postoperative infection,1 repulsion reaction of internal fixation device,and 19 mild occlusion disorder.The differences between the two groups in operation time and postoperative adverse events were statistically significant (P ＜ 0.05),but there was no significant difference in intraoperative blood loss (P ＞ 0.05).There was no significant difference between the ipsilateral △L and contralateral △L in two groups (P ＞ 0.05).No significant difference in △L4 was found (P ＞ 0.05),but there were significant differences in △L1,△L2,△L3,and △L5 between the two groups (P ＜0.05).Conclusion For patients with complex mandibular fractures,the use of computer-aided design and 3D printing model can helps shorten operation time,reduce postoperative adverse events and hence improve the fracture reduction outcome.
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Objective @#To explore the clinical effect of personalized titanium mesh combined with free flap in the repair of maxillary defect.@*Methods@#36 cases of maxillary defect patients as the research object were selected in our hospital during May of 2010 to May of 2016. 36 defect cases were repaired with personalized titanium mesh combined with free flap, and summarize the treatment programs to explore the value of clinical application.@*Results @#By the end of follow-up, all of the flap survived, tumor recurrence rate was 5.56% with paitient satisfaction was 100%; Diplopia and dysphagia occurred in no cases; Masticatory function declined accompanied with a longer chewing time but language communication was not affected.@*Conclusion@# The application of personalized titanium mesh and free flap repair methods in maxillary defect is significant, which effectively improve the quality of life of patients whereas still have difficulties in late denture at the same time.
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Objective This study was to evaluate the clinical outcomes of orbital blowout fracture repair using the individual titanium mesh bent by computer-aided rapid prototyping . Methods The CT imaging data of 11 cases of orbital blowout fracture were analyzed.The subciliary approach was used for the exposure of the fractures .An appropriate 3D-printed titanium mesh pre-bent by computer-aided rapid prototyping was selected and implanted according to the characteristics of a given defect .The surgical results were analyzed by evaluating diplopia , eyeball movement , enophthalmos , and the position of the titanium mesh and comparing the orbital vol-ume before and after surgery . Results All the operations were successfully accomplished .No remolding or trimming was needed for the pre-bent titanium mesh and implanted titanium mesh was tightly fixed to the orbital wall .The patients were followed up for 3 -12 months, which revealed no symptoms of diplopia in any of the patients . Volumetric analysis showed a significantly reduced orbital volume difference from (2.60 ±0.43) mL preoperatively to (-0.07 ±0.62) mL postoperatively (P<0.01).Enophthalmos was desirably correc-ted, with the enophthalmos difference decreased from (2.35 ±0.81)mm preoperatively to (-0.10 ±0.52) mm postoperatively (P<0.01).No extra-ocular muscle limitation was observed . Conclusion The individual titanium mesh bent with computer-aided rapid prototyping technology can be applied to orbital blowout fracture repair , which may achieve a high success rate of anatomic restoration of the orbital volume and effective prevention of enophthalmos .
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To explore the feasibility of rapid proto-typing ( RP) technology in the treatment of Standford type A aortic dissection. 5 patients with Standford type A aortic dissection received computed tomography angiography (CTA) of their aortas. The CTA images were then processed by 3D reconstruction with MIMICS16. 0 in order to create aortic dissection models through RP technology based on real patient aorta size with a ratio of 1 ∶ 1 . Accord-ing to these models, the surgeons were able to fully understand the aortic diseases of patients, thus establish indi-vidualized treatment strategies for each patient. Besides, the surgeons simulated operations on the models, which helped them achieve better results in real surgery. These patients experienced no post-operative complications and were discharged from hospital with recovery. In conclusion, RP technology can provide adequate preoperotive prep-arations for patients with Standford type A aortic dissection, improve operation efficiency and accuracy in aortic dis-section and guide precise proximal anchoring of stents during intracavitary therapy.
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Objective To evaluate the value of computer aided rapid prototyping technology in diagnosis and treatment of complicated pelvic fractures. Methods Twenty-two patients of complicated pelvic fractures were examined by thin-slice CT to gain two-dimensional data of the pelvis. Three-dimensional reconstructions of anatomical models were accomplished by computer aided technology. By rapid prototyping technology , the pelvic models were rendered , by which diagnosis and typing of pelvic fractures were finalized for operation project , mimic operation and guiding the operation. Results Three-dimensional reconstruction images and rapid prototyping pelvic models were extremely similar to what doctors saw in the operations. Preoperative mimic operation shortened the time of operation and reduced the volume of bleeding in the operation. All 22 cases were available for review in follow-up period of 6 ~ 24 months. Patients could sit up in 2 ~ 4 weeks after surgery , and walk with a crutch 6 weeks later. Pelvic fractures reductions were good in 22 cases. According to the Majeed's functional criteria , 16 patients were judged excellent and 3 patients were good. The excellent and good rate was 86.4%. Conclusions Computer aided rapid prototyping technology can overall, direct-viewing, and exactly display the three-dimensional shape of pelvis and spatial relation of anatomic structures. It is important for definite clinic diagnosis , typing and treatment.
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[Objective]We have made the entity model of human being injured irregular bone model by using rapid prototyping technogy,and discussed the value and prospect of rapid prototyping technology in clinical orthopedics.[Method]This group included 23 cases:15 cases of calcaneus fracture,4 cases of fracture of tibial plateau,2 cases of fracture of first lumbar vertebral body,1 case of scapula fracture,1 case of dysplasia and aseptic necrosis of femoral head.According to the data gotten from CT tomographic scan of 23 cases which had fracture of irregular bone,we made the entity model of bone injury using professional software and equipment,and put it into clinic practice to study the state of illness and tried to assist the operative treatment.[Result]Application of rapid prototyping technology helped to study the state of illness and assisted the operative treatment,and brang on a new mechanism of the trauma and operative methods.By using it we also shortened the operative time and reduced the hemorrhage in the operation,and improved the rate of success in the first operation in order to avoid the second operation.All these cases have received good treatment effects.[Conclusion]The rapid prototyping technology has broad prospect in clinical orthopedics.