解剖学报

解剖学报 ›› 2023, Vol. 54 ›› Issue (2): 244-248.doi: 10.16098/j.issn.0529-1356.2023.02.018

• 技术方法 • 上一篇    下一篇

颌骨内异物取出术的手术导板设计和应用

毛梦芸1 王成泽1 朱海华1 樊明星2 吴笑妃3 朱赴东1* 
  

  1. 1.浙江大学医学院附属口腔医院，浙江大学口腔医学院，浙江省口腔疾病临床医学研究中心，浙江省口腔生物医学研究重点实验室，浙江大学癌症研究院，杭州 310006; 2.杭州六维6D牙科科技有限公司，杭州 310000;  3.杭州市余杭区第五人民医院口腔科，杭州 311100
  • 收稿日期:2021-10-13 修回日期:2022-01-06 出版日期:2023-04-06 发布日期:2023-04-06
  • 通讯作者: 朱赴东 E-mail:zfd@zju.edu.cn
  • 基金资助:
    浙江省属基本科研业务费专项资金资助;中国牙病防治基金会

Design and validation of a surgical guide for the retrieval of foreign body instruments in jaw

MAO  Meng-yun1  WANG Cheng-ze 1  ZHU  Hai-hua1  FAN  Ming-xing2  WU  Xiao-fei3  ZHU  Fu-dong1*    

  1. 1.Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases  of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University,  Hangzhou  310006, China;  2.Hangzhou 6D Dental Tech Co, Ltd, Hangzhou 310000, China; 3.Department of Stomatology,  the Fifth People’s Hospital of Yuhang District, Hangzhou 311100, China
  • Received:2021-10-13 Revised:2022-01-06 Online:2023-04-06 Published:2023-04-06
  • Contact: ZHU Fu-dong E-mail:zfd@zju.edu.cn

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摘要：

目的 设计一款辅助颌骨内异物取出术的新型手术导板，并进行体外模型评估和临床验证。   方法  基于锥形束计算机断层扫描数据和环钻技术，自主设计颌骨内异物取出术的外科手术导板，通过体外羊下颌骨模型评估该导板的可行性和准确性，并将其成功应用于临床病例。通过在柱状骨的六角和顶点处测量7个参数（cdh、cda、hdh、hda、vdh、vda和ad）距离，计算轴偏移角，评估实际去除和计划去除圆柱状骨之间的线性和角度偏差。   结果  体外模型显示该导板的六角和顶点的平均中心偏差分别为(0.51±0.14) mm和(0.62±0.19) mm。六角处的水平偏差为(0.48±0.16) mm，顶点处的水平偏差为(0.52±0.22) mm，六角处的垂直偏差为(0.17±0.09) mm，顶点处的垂直偏差为(0.29±0.13) mm，角度偏差为（5.38±3.43）°；在临床病例中，术者在导板帮助下，成功定位并取出了颌骨内断裂的根管锉。   结论  本款新型手术导板能够有效辅助目标性定位和微创性取出颌骨内断裂器械等异物。 

关键词:  手术导板, 下颌骨异物, 锥形束计算机断层扫描, 羊

Abstract:

Objective  To design and validate a novel surgical guide for retrieval of foreign body in jaw.     Methods Firstly, a surgical guide based on cone beam computed tomography and trephine technique was designed to remove broken dental instrument fragments. Its feasibility and accuracy were assessed by removing broken dental instrument in goat mandible, and then it was successfully applied in clinical cases. The linear and angular discrepancies between actual and planned columnar bone with imaginary fragment was analyzed. The euclidean distance was measured at the hex and apex of the columnar bone and the angle of axis deviation was also calculated. We obtained seven parameters (cdh, cda, hdh, hda, vdh, vda, and ad) to describe deviations.    Results  Mean central deviation at the hex and apex was (0.51 ± 0.14) mm and (0.62 ± 0.19) mm, respectively. Accompanying mean values were as follow: horizontal deviation at the hex was (0.48 ± 0.16) mm, horizontal deviation at the apex was (0.52 ± 0.22) mm, vertical deviation at the hex was (0.17 ± 0.09) mm, vertical deviation at the apex was (0.29 ± 0.13) mm, and angular deviation of (5.38 ± 3.43) degrees. In a clinical case, the guide successfully located and removed the fracture file.    Conclusion  This study reveals that this kind novel surgical guide could aid to locate and remove the foreign body in jaw. 

Key words: Surgical guide, Foreign body in mandible, Cone-beam computed tomography, Goat

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