选区激光烧结技术在复杂颌面骨骨折中的临床应用研究

【作者】 李慧；

【导师】 南欣荣； 令狐清溪；

【作者基本信息】 山西医科大学 ， 口腔医学， 2006， 硕士

【摘要】 目的:利用选区激光烧结技术对干燥头颅骨进行复制,研究激光烧结技术精度,研究建立颌面部复杂骨折内固定的快速成型系统,并通过二例骨折的辅助修复,验证该系统的可行性和实用性。材料与方法:1、本课题对一例干燥头颅骨标本进行螺旋CT扫描,层厚1.0mm,螺距1.0,并进行三维重建, CT图像进行灰度、对比参数的调整后,导入MIMICS8.1软件,进行滤波,二值化,轮廓提取,分割,插值等处理,矢量叠加后得到头颅骨的三维模型,转化为STL格式文件,输入快速成形机,加工得到头颅骨的三维仿真模型。2、应用选区激光烧结快速成型系统对二例颌面部复杂骨的病人进行颌骨骨折区域的模型复制,并在模型上进行手术设计,预制钛板,模拟手术过程,并以此为参考对病人进行骨折内固定修复。术后进行评价,以验证选区激光烧结快速成型系统临床应用的可行性。结果:1、分别测量头颅骨标本及模型x,y,z方向的距离,头颅骨标本及模型部分解剖区的厚度。在外轮廓上,在x,y,z三个方向精度可达1mm左右,复制所得头颅骨模型与标本解部外形基本一致。在骨质较薄及锐区,精度较低,最大误差达1.5mm。制作费用降低,制作过程缩短,为临床的使用奠定了基础。2、应用选区激光烧结快速成型系统辅助对二例颌面部复杂骨的病人进行坚固内固定修复,缩短了手术时间,较好的恢复了面部形态及咬合功能。手术效果令人满意。结论:反求工程与选区激光烧结快速成型技术辅助完成颌面骨复杂骨折的坚固内固定,降低了手术难度,提高了手术的精度,缩短了手术时间,解决了在颌面骨复杂骨折治疗过程中骨折复位难,面形以及咬合功能恢复不理想,手术时间较长等问题,在颌骨复杂骨折整复中具有独特的优势,具有较好的应用前景。更多还原

【Abstract】 1Object:The purpose of this research is to study the precision of the selective laser singtering model, create a system technique for maxillofacial fracture and apply the technique for 2 patients to complete the method.Material and method:1. spiral CT scans to a dried cranial bone sample, thickness at 1.0mm intervals, were generated on spiral CT scanning system. Surface reconstruction was done for three images. The paper gives a method in which the filtration, binarization, bone’s contour extraction and vectorization is done orderly. And CT data was converted to STL format. The STL file was inputted into the rapid apparatus. The 3D stereo-temporal bone physical model was built layer by layer.2. Head spiral CT scan was given to a patient who had maxillofacial fracture from an accident. The 3D stereo-temporal bone physical model was manufactured by selective laser singtering from the digitized data. To design of the operation, to prefabricate the titanium plate and to simulate the operation process. Then the operation was carried on patients by this. Evaluate the operation effect.Result:1. Physical model of the cranial bone was measured at x y z directions. The precision on the outline of the model was about 1mm, according to the dried cranial bone sample. But, the error was about 1.5mm on the thick and sharp parts. In this research, the experience and time consuming was lower than before.2. The selective laser singtering system technique for maxillofacial fracture and apply the technique for patients to complete the method. This technique can recover the face form and function of the occlusion.Conclusion:The selective laser singtering system technique is helpful and useful in maxillofacial fracture. It may be widely used in future.更多还原