【摘要】 目的研究计算机三维手术模拟系统在利用自体喙突移植再造双侧颞下颌关节强直患者髁突关节成形术中的应用及其临床效果。方法对2007~2009年我院收治的8位双侧颞下颌关节骨性强直患者,利用Surgicase CMF软件行术前设计和三维手术模拟并行相关测量。在相关数据的指导下行双侧强直块切除术、自体喙突游离移植再造髁突。术后行临床检查,放射检查等对骨瓣愈合情况和颞下颌关节功能进行评价。结果术后患者获得良好的开口度与咬合关系。曲面体层X线片示,所有患者的移植喙突位于关节窝内,愈合良好;喙突有一定吸收,但未引起咬合的明显改变。随访期间未有复发患者,无其它明显并发症。结论在自体喙突移植再造双侧颞下颌关节强直患者髁突成形术中应用计算机辅助三维手术模拟系统可以使得手术更加精确和方便,提高了患者的满意度。更多还原

【Abstract】 Objective To describe the use of computer-assisted three-dimensional surgical planning in condylar reconstruction in patients with bilateral temporomandibular joint ankylosis using autogenous coronoid process and to explore its clinical effects.Methods Eight patients with bilateral temporomandibular joint bony ankylosis who visited our hospital from 2007 to 2009 were treated by bilateral ankylosed blocks resection and condylar reconstruction by free grafting of autogenous coronoid process with three-dimensional simulation using Surgicase CMF Materialise software.Clinical examination,radiograph,photograph,and details of operation and outcome were evaluated postoperatively to determine the clinical effects of the technique.Results Satisfactory mouth opening and occlusion were achieved in all cases.Radiographic examination showed that transplanted coronoid processes were all located in the mandibular fossa.Some bone resorption of the grafted coronoid process was observed,but no apparent occlusal changes were noted.Neither recurrence nor other obvious complication occurred.Conclusion Computer-assisted three-dimensional surgical planning and simulation combined with free grafting of autogenous coronoid process may be a suitable alternative to the reconstruction of condyles for patients with bilateral temporomandibular joint ankylosis,making the operation more accurate and more convenient.更多还原