Application of computer-aided design and 3D printing model in operation for complex mandibular fractures / 中华创伤杂志

ABSTRACT

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 (△L1the difference between the mandibular angle point and the condyle apex;△L2the difference between the mandibular angle point and the chin vertex;△L3the difference between the apex of the chin and the apical point;△L4the difference between the inner mandibular angle point and the Inferior alveolar margin point;△L5the 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.