基于CBCT实现术前下颌骨模型的数字化钉道转移及其在下颌骨骨折中的初步应用

doi:10.13591/j.cnki.kqyx.2025.02.005

摘要/Abstract

摘要：

目的本研究旨在通过锥形束CT(CBCT)对记录有钉道信息的熔融沉积(FDM)打印下颌骨模型进行扫描并精确重建,以实现术前模型的数字化钉道转移。方法对12例用于重建板预弯的FDM打印下颌骨模型(Model1组)进行CBCT扫描,并使用Mimics软件对扫描数据进行重建,得到颌骨模型(Model2组),并提取数字化钉道信息。将Model2与原始模型(Model0组)进行三维比较,通过平均均方根误差(RMS)评估重建模型的精度。通过优化重建参数,使Model2与Model0自动匹配,实现精准的数字化钉道转移。利用该方法制作数字化分段式钉道转移导板,应用到临床中,辅助3例下颌骨骨折患者完成复位手术。结果 Model2能够与Model0自动匹配,并具有良好的表面细节,钉道位置和方向信息清晰,RMS为(0.32±0.09)mm。3例下颌骨粉碎性骨折患者通过数字化分段式钉道转移导板辅助复位手术,效果令人满意。结论通过CBCT扫描FDM打印的术前模型可以准确获取钉道的位置和方向信息,实现数字化钉道转移,为精准设计数字化手术导板提供了一种新方法。

关键词: 分段式钉道转移导板, 虚拟手术计划, 熔融沉积成型, 下颌骨骨折

Abstract:

Objective To scan and accurately reconstruct mandible models printed via fused deposition modeling(FDM) that contain screw path information, using cone-beam CT(CBCT), to achieve the digital transfer of preoperative model screw paths. Methods CBCT scans were conducted on 12 FDM-printed mandibular models(Model1 group)intended for prebending reconstruction plates. Mimics software was employed to reconstruct scanned data into mandibular models(Model2 group) and extract digital screw path information. Model2 was then compared with original models(Model0 group) in three dimensions, evaluating reconstruction accuracy through root mean square(RMS). Reconstruction parameters were optimized to enable automatic matching of Model2 with Model0, facilitating precise digital transfer of screw paths. In clinical application, this method was utilized to produce digital short-segment drilling guides, assisting in the reduction surgery of three mandibular fracture patients. Results Model2 demonstrated automatic matching with Model0, exhibiting detailed surface characteristics and clear screw path position and orientation information. The RMS was measured at (0.32±0.09)mm. Utilization of digital segmented screw path transfer guides assisted in the satisfactory reduction surgery of three patients with comminuted mandibular fractures. Conclusion CBCT scanning of FDM-printed preoperative models accurately captures screw path position and orientation information, enabling digital transfer of screw paths and providing a novel method for precise design of digital surgical guides.

Key words: short-segment drilling guides, virtual surgical planning, fused deposition modeling, mandibular fracture

中图分类号:

R782.4

万右军, 张天禹, 朱博文, 朱榴宁, 卜寿山, 庄海. 基于CBCT实现术前下颌骨模型的数字化钉道转移及其在下颌骨骨折中的初步应用[J]. 口腔医学, 2025, 45(2): 105-111.

WAN Youjun, ZHANG Tianyu, ZHU Bowen, ZHU Liuning, BU Shoushan, ZHUANG Hai. Digital screw path transfer of preoperative mandibular models using CBCT and its preliminary application in mandibular fractures[J]. Stomatology, 2025, 45(2): 105-111.

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病例	RMS
病例	Model2-0	Model2-1	Model2-2	Model2-3	Model2-4	Model2-5
1	无法匹配	2.63	2.37	0.27	0.27	0.27
2	无法匹配	0.33	0.32	0.32	0.33	0.34
3	无法匹配	0.88	0.88	0.31	0.31	0.33
4	1.99	1.20	0.76	0.40	0.37	0.36
5	1.03	1.24	0.64	0.54	0.52	0.45
6	2.98	0.27	0.19	0.18	0.18	0.18
7	无法匹配	2.47	0.27	0.27	0.28	0.28
8	无法匹配	3.00	0.42	0.32	0.28	0.26
9	1.84	1.07	0.22	0.24	0.23	0.23
10	无法匹配	0.64	0.52	0.34	0.32	0.31
11	3.93	0.26	0.25	0.27	0.29	0.30
12	无法匹配	0.84	0.46	0.37	0.24	0.29
平均值		1.24±0.95	0.60±0.60	0.32±0.09	0.30±0.09	0.30±0.07