CN104473705A - Head maxillofacial bone implant and method for quickly molding same - Google Patents
Head maxillofacial bone implant and method for quickly molding same Download PDFInfo
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- CN104473705A CN104473705A CN201410718420.3A CN201410718420A CN104473705A CN 104473705 A CN104473705 A CN 104473705A CN 201410718420 A CN201410718420 A CN 201410718420A CN 104473705 A CN104473705 A CN 104473705A
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Abstract
The invention relates to a head maxillofacial bone implant and a method for quickly molding the same. The method is particularly a processing method for prosthesis for defects of the facial bones of human bodies, and the prosthesis is obtained by the aid of a processing technology for quickly polymerizing and molding powder. The method includes constructing maxillofacial post-traumatic models of patients according to image data of the bones of the patients; manufacturing three-dimensional models according to treatment repair requirements of clinical doctors by means of symmetric mirroring, curve design, database matching and the like. The image data of the bones of the patients are acquired by the aid of image diagnostic techniques such as CT (computed tomography) or MRI (magnetic resonance imaging). The three-dimensional models are matched with the traumatic positions of the patients. The head maxillofacial bone implant and the method have the advantages that the prosthesis models can be molded by the aid of the processing method for quickly molding the implant, and accordingly the prosthesis can be manufactured; the prosthesis which is processed in a personalized manner can be designed and processed for the patients with the maxillofacial defects and particularly patients with complicated defect structures, and the prosthesis with an anatomical repair effect and an effect of recovering functions of the maxillofacial organs of the patients can be manufactured.
Description
Technical field
The present invention relates to Bone Defect Repari implant field, particularly relate to the head Maxillary region bone implant for head Maxillary region Bone Defect Repari and quick molding method thereof.
Background technology
For Bone Defect Repari implant, domestic have
utility modelthe skull bone implant of patent documentation 1, specifically comprise skull prosthese, the outer surface of described skull prosthese has tantalum coating, namely adopt good biocompatibility, corrosion-resistant, wear-resistant, with the high metal tantalum of substrate combinating strength as coating material.
And in whole skull, orbit wall fracture and bony defect are piths, also be the common a kind of disease of clinical ophthalmology, its reason is usually because injure the bony defect caused after vehicle accident etc. causes comminuted fracture or orbital tumor excision outside eye.Certainly, variously outer the caused head Maxillary region bone fracture such as accident are injured and bony defect is also have suitable ratio.
And eye frame fracture can cause the symptoms such as diploma and movement limited therapy, the socket of the eye wall defect after partial fracture also has a strong impact on the facial appearance of patient, and serious fracture and defect must pass through the means such as operative reduction and packing material and repair.Because the complex structure at orbit wall bony defect position, defective region is irregularly shaped usually, patient's
traumatic conditionvary with each individual, ever-changing, usually lack the suitable implant of shape, operation often can only reach ball portions functional rehabilitation, cannot complete anatomical reduction, the restriction of the packing material characteristic that the quality of operation technique is also implanted.The restriction of these materials brings immeasurable fluctuation to the repairing quality that orbit wall is damaged, be difficult to postoperative functional rehabilitation be controlled in satisfied degree, the complication such as optic nerve injury, Limit of ocular movements can be again there is in follow-up healing processes of bone fracture, simultaneously may be attractive in appearance with face impact of subsiding.
Repair materials at present for orbit wall defect mainly comprises autologous bone, allograph bone, artificial material and biomaterial etc.Although autologous bone can avoid immunological rejection completely, increase the survival probability of implant, but because the size shape of drawing materials and size are restricted, only have small part patient to have ready conditions and utilize autologous bone transplanting to fill socket of the eye wall defective region, even if complete autologous bone transplanting smoothly, implant also to be considered because whether the factors such as blood supply ensure the problem that osteocomma is survived.For allograph bone, the most serious complication is exactly postoperative rejection, causes implanting osteocomma survival rate not high.Therefore artificial material implant causes more concerns of this area, artificial material mainly hydroxyapatite complex (artificial bone), high-density porous polyethylene synthetic material (Medpor), titanium metal material and absorbable material etc. conventional at present.Wherein hydroxyapatite and high-density porous polyethylene material have the features such as bio-compatibility is good, plasticity is good, intensity is large, mainly be used to fracture, orbital floor fracture etc. in pure socket of the eye, but these materials are because the porosity of its material is not enough, the Interior Wall Fracture larger for scope can not correct profile completely, and its use is restricted; Absorbable material mainly uses poly-L-third to hand over fat (PLLA), have good biological activity and osteanagenesis inductivity, can degrade in vivo, final metabolism is water and carbon dioxide, harmless, on imaging diagnosis and radiotherapy without impact.Implant 8 weeks time can ensure can absorb for about 80%, one year of initial strength, Among Children patient can be applicable to, but because its degradation speed difficulty controls, for osteanagenesis slowly patient usually there will be unexpected failure.Titanium metal material has good tissue compatibility, corrosion resistance is strong, mechanical strength is suitable, the compatible feature such as good of surface biological and receiving much attention, more and more be applied to clinical, conventional is the prefabricated titanium net that pure titanium material makes at present, its proportion is lighter, patient's self-induction is comfortable, titanium material does not affect the inspection such as NMR (Nuclear Magnetic Resonance)-imaging (MRI) or computed tomography (CT) simultaneously, accept MRI after being convenient to operation in patients and check check nerve recovery situation, more and more accepted by clinician.
But materials all is at present all on a kind of basis of general preformed shape, in art, prune implant by surgical doctor according to the wound surface defect situation scene of patient.Comprise titanium net, these preformed materials all make under same model, there is a basic shape, be difficult to coincide with the Cranial defect wound surface of patient, because the anatomical structure of each patient each warp parameter is different, wound is different from defect degree, the shape need of the head Maxillary region bone implant comprising socket of the eye wall implant to be varied with each individual, different due to wound.In operation, surgical doctor is in the face of the wound surface of head Maxillary region Cranial defect, need to carry out scene processing to preformed material, bend, moulding, pruning, the operating process such as wound surface comparison, again pruning, not only extend the open-assembly time of wound surface, further increase in the moulding comparison process of material and the stimulation of wound surface soft tissue is damaged, too increase the probability of wound surface Infection in operation, likely cause the infringements such as postoperative soft tissue repair time-histories prolongation.Simultaneously because of the difference that manual alignment is moulding, be difficult to reach the requirement of satisfied perfect anatomical reduction, cause postoperative face and eye socket functional rehabilitation to be restricted.
In addition, the difference between the shape of preformed material and actual demand brings very large trouble and post-operative complication to performing the operation,
as Fig. 7cT tomoscan
figure instituteshow.Cause frame content outstanding to nasal cavity after patient's nasal endoscope, operation employs hydroxyapatite hone lamella and fills (arrow indication place), due to hone lamella thickness and the Space mismatching needing to fill, patient placed 2 layers of hone lamella and is used for padded orbit wall, reach the object supporting eyeball, anatomical reduction is imperfect on the one hand, on the other hand, whether the fixing of postoperative multilamellar hone lamella can cause displacement because of the motion of patient, be all the factor causing operative failure.
Again specific to head Maxillary region bone implant and quick molding method thereof, do not have existing technology and patent documentation at present.
Prior art document
Patent documentation
Patent documentation 1:CN202801865U
Summary of the invention
Problem to be solved by this invention is, personalized designs and personalized prefabricated head Maxillary region bone implant and quick molding method thereof are provided and can pass through to use described head Maxillary region bone implant, effectively shorten operating time, more decrease the damage to surgical wound surface soft tissue, be conducive to quick recovery after operation in patients.
The present invention relates generally to following technical scheme:
1, head Maxillary region bone implant, is characterized in that: rebuild head Maxillary region bone 3 D stereo according to the visual diagnostic data of CT or MRI at the position of patient's head Maxillary region bone injury
figurepicture, according to the Treatment need of doctor, the 3 dimensional format file being gone out personalized head Maxillary region bone implant by computer-aided design molded design, utilizes rapid shaping technique to mold the head Maxillary region bone implant of design.
2, the head Maxillary region bone implant as described in above-mentioned 1, it is characterized in that, the design of described head Maxillary region bone implant carries out with ground or strange land personalized designs according to the 3-dimensional image diagnostic scan data of the 3-dimensional image diagnostic scan data directly obtained or remote transmission, and carry out corresponding personalized prefabricated.
3, the head Maxillary region bone implant as described in above-mentioned 1 or 2, it is characterized in that, the area of computer aided forming technique of described head Maxillary region bone implant be mainly skull model is carried out splitting mirror image, curved surface guide rebuild, the method for database data coupling repairs described head Maxillary region bone implant.
4, the head Maxillary region bone implant according to any one of above-mentioned 1 ~ 3, is characterized in that, described head Maxillary region bone injury comprises the Cranial defect in the complexity reparation situation of the bony defect after orbit wall comminuted fracture, orbital tumor excision.
5, the head Maxillary region bone implant according to any one of above-mentioned 1 ~ 4, it is characterized in that, described head Maxillary region bone implant powder melts clustering technique manufacture, uses the material being applicable to powder processing molding comprising pure titanium metal, titanium alloy, pottery or macromolecular material.
The quick molding method of the head Maxillary region bone implant 6, described in above-mentioned 1 ~ 5 any one, is characterized in that, comprising:
The raw video data file obtained by the scanning of CT or MIR, rebuilds head Maxillary region bone 3 D stereo
figurethe step of picture,
Three-dimensional according to head Maxillary region osteocranium bone
figurepicture, designs the shape of personalized skull Maxillary region bone implant, and is converted into the step of the file of Software of RP System identification, and
The head Maxillary region bone implant utilizing rapid shaping technique molding previous step to design and former defect model, and both are compared, determine the step of design rationality.
The quick molding method of the head Maxillary region bone implant 7, described in above-mentioned 6, is characterized in that, also comprise: the head Maxillary region bone according to patient damages
traumatic conditioncondition, based on the demand of doctor to treatment, carries out personalized designs to head Maxillary region bone implant, and carries out corresponding personalized prefabricated step.
The quick molding method of the head Maxillary region bone implant 8, as described in above-mentioned 6 or 7, it is characterized in that, also comprise: the design of described head Maxillary region bone implant carries out segmentation mirror image based on skull model, curved surface guides the methods such as reconstruction, database data coupling to carry out repairing etc. step to intraorbital implantation body; Described rapid shaping technique comprises laser melting coating, electron beam melting.
The quick molding method of the head Maxillary region bone implant 9, according to any one of above-mentioned 6 ~ 8, it is characterized in that, described head Maxillary region bone implant is made up of powdered polymeric process technology, uses the material being applicable to powder processing molding comprising pure titanium metal, titanium alloy, pottery or macromolecular material.
Application in the complicated repair process of the bony defect that the head Maxillary region bone implant 10, according to any one of above-mentioned 1 ~ 5 causes after comprising all kinds of comminuted fracture of head Maxillary region, total surgical resection.
Invention effect
One. because prefabricated head Maxillary region bone implant is according to 3-D scannings such as CT or MRI of patient
figurepicture data personalized designs and manufacture, do not need in operation to carry out the modifications such as pruning, not only effectively shorten operating time, more decrease the damage to surgical wound surface soft tissue, is conducive to quick recovery after operation in patients.
Two. anatomical reduction rebuilds head Maxillary region anatomical structure effectively, effectively ensures the recovery of each several part organ dysfunction, such as: ocular movement, the beauty treatment of the cheekbone bridge of the nose, upper jaw bone reparation etc.More effectively can avoiding fracturing stump to the stimulation and the restriction that are close to soft tissue, also can preventing extruding and the stimulation to being close to neural or blood vessel.
Three. the beauty treatment reparation after operation in patients can be completed to greatest extent.
Four. effectively avoiding the waste of raw materials phenomenon in implant manufacture process, decrease manufacturing cost, reduce further the price of head Maxillary region bone implant, is the direct technology meeting solution " high cost of getting medical treatment " problem.
Five. at utmost play the advantage of powdered polymeric processing technique, utilize three-dimensional printing technology, disposablely can complete the manufacture process of the irregular molding implant of labyrinth and fine structure.
Six. utilize the powdered metallurgical materials such as pure titanium metal to manufacture head Maxillary region bone implant; not only maintain good tissue compatibility; there is good tissue intensity and stability; the inspection such as CT or NMR (Nuclear Magnetic Resonance) imaging (MRI) is carried out after being more conducive to operation in patients; because this type of patient often with the pathological changes of optic nerve and basis cranii nerve, usually can need periodically to check the inspections such as CT or MRI.This advantage of the materials such as pure titanium metal is that other metal materials are incomparable.
Accompanying drawing explanation
fig. 1represent the skull by CT scan data reconstruction
figurepicture (
fig. 1a) skull and after repairing
figurepicture (
fig. 1b) contrast
figure.
fig. 2represent the concrete manufacturing process of the present invention
figure.
fig. 3represent the skull by CT scan data reconstruction defect
figurethe process of picture.
fig. 4represent segmentation and mirror image two kinds of computer-implemented methods.
fig. 5represent reparation
fig. 3shown in defect result and
figureas the result of upper comparison.
fig. 6represent the defect repair body and skull model prepared through quick molding method.
fig. 7represent that existing method is for eye socket bone implant one example
figure.
fig. 8represent that existing method is for another example of eye socket bone implant
figure.
Detailed description of the invention
Below, the head Maxillary region bone implant of embodiment and quick molding method thereof are described and use the specific embodiment of this head Maxillary region bone implant.
Carry out three-D CT scanning by the position of computed tomography (CT) to head Maxillary region bone injury, according to the 3 d scan data obtained and
figurepicture is rebuild, and can see the 3 D stereo image of patient's orbit wall bony defect, and can estimate various warp parameter and the volume of defect.
as Fig. 1shown in.
fig. 1a is the CT scan of three-dimensional reconstruction
figurepicture display eye socket upper arm bony defect extends to frontal bone part.And
fig. 1b: (speckle regions) shown in arrow is the fill area that plan is rebuild.Ophthalmologist can according to rebuild
figurepicture parameter, determines the shape and size of implant.
But, traditional prefabricated component process technology mainly lathe grinding or injection molding, in the face of irregular shape, lathe grinding technology cannot be put to good use; Need to realize making accurate mould based on die forming and injection molding technology, the cost of manufacture of mould is very expensive; And the situation of each patient is had nothing in common with each other, a mould can only be applicable to a people, and mould is also difficult to the processing realizing some irregular fine structures and hole.The difficulty of these processing technique limits carries out prefabricated industrialized development to orbit wall implant.The present invention is just according to three-dimensional
figurethe implant shape designed in advance as reconstruction technique can fit like a glove with bony defect district, and " three-dimensional printing technology " (3D printing) printing technique just can solve above various problems.
Along with the development of rapid shaping technique, 3D starts to be applied to metal manufacturing.Three-dimensional printing technology is defined as in early days " stereolithography technology " (Stereolithography), be mainly used in the materials such as macromolecule resin, operation principle is the process that system passes through order layering superposition, the mode creating multiple cross section generates three-dimensional body object, belongs to and increases material manufacturing technology.Its ultimate principle first sets up three-dimensional by computer aided design software (CAD) or computer animation modeling software
figurepicture model, again the threedimensional model " subregion " built up is become cross section successively, print command is transferred to printer, printer is by the cross sectional information in file reading, with the material of liquid, powdery or lamellar, by these cross sections, " printing " out layer by layer, again each layer cross section be glued together in every way thus produce an entity, theoretically, utilizing this technology can complete the device manufacture of any shape, any hole.The metal material print system of superlaser or direct electron beams is developed in 3 D-printing field in recent years, in conjunction with titanium valve manufacturing technology, the 3 D-printing manufacturing technology of pure titanium metal material devices is become a reality.The pure titanium three-dimensional printer that Acram company of Sweden produces has higher resolution, can pass through the three-dimensional designed in advance at short notice
figureas the disposable substitute or the implant that produce pure titanium human organ, more outstanding advantage is at personalized three-dimensional
figureon the basis that picture is rebuild, disposablely can complete the manufacture of the implant of irregular, various pore structure.
The development of the three-dimensional printing technology of pure titanium metal powder, allows personalized implant create reality.This advantage has exactly met ophthalmologist for the designing requirement of irregular head Maxillary region bone implant and processing technology requirement.The present invention will for this technology, complete the Study on Transformation of clinical practice: develop a kind of personalized three-dimensional and print the pure titanium head Maxillary region bone implant manufactured, that is: three-D CT scanning is carried out to the position of head Maxillary region bone injury, according to the three-D CT scanning data reconstruction head Maxillary region bone 3 D stereo obtained
figurepicture, molds the shape and size of head Maxillary region bone implant, utilizes 3 D-printing to go out the head Maxillary region bone implant of forming shape and size.For solving reparation, the cosmetic problem of clinical ophthalmology socket of the eye wall bony defect patient, provide a kind of new technical scheme and the choice of technology.
In addition, three-dimensional printing technology can according to the situation of patient, requirement, processing etc., suitably select the material that prints and print the head Maxillary region bone implant of various material, such as, except pure titanium metal, titanium alloy, pottery or macromolecular material etc. can also be selected, as long as certainly the material of 3 D-printing can be applicable to, just do not limit, can use.
The present invention explore a kind of clinical with manufacture and design the personalized medicine pattern of combining closely, the design of head Maxillary region bone implant can be carried out with ground or strange land personalized designs according to the three-D CT scanning data of the three-D CT scanning data directly obtained or remote transmission, and carries out corresponding personalized prefabricated.
Specifically, utilize network communications technology to set up the service system in the energy radiation whole nation, namely comprise following 4 parts:
(1), collect the impact of Clinical CT inspection by clinician and pass to configuration design engineer.
(2), through the Joint Designing of doctor and configuration design engineer and reconstruction, the implant shape met with defect is designed.
(3), by rapid shaping technique, the printing of implant and defect model and comparison in kind is completed.
(4), dummy and defect model will be implanted after the process such as sterilization wrap, and send back to clinician, help it to complete clinical operation.
The present invention will be described in more detail below to utilize embodiment, but the present invention is not by any restriction of embodiment.
Embodiment 1
Research method
as Fig. 2shown in, key step is as follows:
1. the clinical DICOM file utilizing CT scan to obtain, rebuilds the three-dimensional of skull
figurepicture.
2. the bone defect healing body of design personalized, and export the file of rapid prototyping system identification.
3. the personalized bone defect healing body of molded design and skull model.
4. by comparison, confirm the effectiveness of bone defect healing body and carry out surgical guidance.
To the concrete process implemented, be described below:
The first step, patient seeks medical advice because left orbit wall fracture occurs a variety of causes, obtains data file, rebuild the skull situation of patient by CT scan.
as Fig. 3shown in.
Second step, by computer-implemented methods such as segmentation, mirror image, fusion, curve reestablishings, designs the implant matched with patient's orbital defects department.
fig. 4show segmentation and mirror image two kinds of computer-implemented methods.
3rd step, carries out original position comparison to the implant cast designed and former defect model, confirms its effectiveness.
as Fig. 5shown in, implant cast and former defect location match.
4th step, rapid shaping implant cast and defect of skull model, and compare with material object.
as Fig. 6shown in.
5th step, implants the implant printed, completes the treatment of orbital defects in corrective surgery.
The personalized designs to patient can be accomplished in whole process, fit like a glove with fractures, do not need in operation to carry out the modifications such as pruning, not only effectively shorten operating time, more decrease the damage to surgical wound surface soft tissue, ensure and be beneficial to quick recovery after operation in patients.
Comparative example 1
L Head And Face traumatic patient, CT tomoscan
figure (Fig. 5upper
figure) and CT three-dimensional imaging
figure (Fig. 5a left side
upper figure) display right side roof of orbit bony defect upper jaw bone multiple fracture, and be subjected to displacement, right eye orbital floor fracture subsides, and maxillary sinus disappears, and nasal cavity subsides.Patient's outward appearance facial deformation, right forehead subsides, and has a strong impact on attractive in appearance.Implant after titanium net is moulding and repair right eye root of orbit and right side temporal bone, use hydroox apatite artificial bone plate filling right eye paries inferior orbitae simultaneously, because the restriction of artificial bone plate thickness, carried out the filling of multilamellar hone lamella.Postoperative CT tomoscan
figurepicture (
fig. 7the right side
figure below) recovery of display eye socket functional areas, postoperative patient beautifying face is significantly improved, but right nasal cavity subsides not yet effectively to be corrected.
Comparative example 2
On the left of patient, roof of orbit defect extends to left side frontal bone and skull, causes left forehead to subside, three dimensional CT display root of orbit and forehead large area bony defect, in operation after the titanium net of shaped by hand is implanted, rebuild root of orbit structure, postoperative patient face face is close to normal, but CT tomography
figurealthough the titanium net of picture display shaped by hand supports root of orbit structure, compared with offside, slightly owe symmetrical, this is one of unavoidable shortcoming of shaped by hand.Specifically see
fig. 8.
Utilizability in industry
The present invention can provide personalized designs and personalized prefabricated head Maxillary region bone implant and quick molding method thereof, and can by using described head Maxillary region bone implant, effectively shorten operating time, more decrease the damage to surgical wound surface soft tissue, be conducive to quick recovery after operation in patients, effectively ensure the recovery of each several part organ dysfunction, such as: ocular movement, the cheekbone bridge of the nose is improved looks, upper jaw bone reparation etc., can widely use in Bone Defect Repari field, and can remote transmission data, carry out personalized designs and personalized prefabricated, have a extensive future.
Claims (10)
1. head Maxillary region bone implant, it is characterized in that: rebuild head Maxillary region bone three-dimensional image according to the visual diagnostic data of CT or MRI at the position of patient's head Maxillary region bone injury, according to the Treatment need of doctor, the 3 dimensional format file being gone out personalized head Maxillary region bone implant by computer-aided design molded design, rapid shaping technique is utilized to mold the head Maxillary region bone implant of design.
2. head Maxillary region bone implant as claimed in claim 1, it is characterized in that, the design of described head Maxillary region bone implant carries out with ground or strange land personalized designs according to the 3-dimensional image diagnostic scan data of the 3-dimensional image diagnostic scan data directly obtained or remote transmission, and carry out corresponding personalized prefabricated.
3. head Maxillary region bone implant as claimed in claim 1 or 2, it is characterized in that, the area of computer aided forming technique of described head Maxillary region bone implant be mainly skull model is carried out splitting mirror image, curved surface guide rebuild, the method for database data coupling repairs described head Maxillary region bone implant.
4. the head Maxillary region bone implant according to any one of claims 1 to 3, is characterized in that, described head Maxillary region bone injury comprises the Cranial defect in the complexity reparation situation of the bony defect after orbit wall comminuted fracture, orbital tumor excision.
5. the head Maxillary region bone implant according to any one of Claims 1 to 4, it is characterized in that, described head Maxillary region bone implant powder melts clustering technique manufacture, uses the material being applicable to powder processing molding comprising pure titanium metal, titanium alloy, pottery or macromolecular material.
6. the quick molding method of the head Maxillary region bone implant described in any one of Claims 1 to 5, is characterized in that, comprising:
The raw video data file obtained by the scanning of CT or MIR, rebuilds the step of head Maxillary region bone three-dimensional image,
According to head Maxillary region osteocranium bone 3-D view, design the shape of personalized skull Maxillary region bone implant, and be converted into the step of the file of Software of RP System identification, and
The head Maxillary region bone implant utilizing rapid shaping technique molding previous step to design and former defect model, and both are compared, determine the step of design rationality.
7. the quick molding method of head Maxillary region bone implant according to claim 6, is characterized in that, also comprise:
According to the head Maxillary region bone injury situation of patient, based on the demand of doctor to treatment, personalized designs is carried out to head Maxillary region bone implant, and carry out corresponding personalized prefabricated step.
8. the quick molding method of head Maxillary region bone implant as claimed in claims 6 or 7, is characterized in that, also comprise:
The design of described head Maxillary region bone implant carries out segmentation mirror image based on skull model, curved surface guides the methods such as reconstruction, database data coupling to carry out repairing etc. step to intraorbital implantation body; Described rapid shaping technique comprises laser melting coating, electron beam melting.
9. the quick molding method of the head Maxillary region bone implant according to any one of claim 6 ~ 8, it is characterized in that, described head Maxillary region bone implant is made up of powdered polymeric process technology, uses the material being applicable to powder processing molding comprising pure titanium metal, titanium alloy, pottery or macromolecular material.
10. the application in the complicated repair process of the bony defect that the head Maxillary region bone implant according to any one of Claims 1 to 5 causes after comprising all kinds of comminuted fracture of head Maxillary region, total surgical resection.
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| CN112656567B (en) * | 2020-12-18 | 2022-11-08 | 上海交通大学医学院附属第九人民医院 | Method for manufacturing external fixation helmet for severe maxillofacial fracture |
| RU218810U1 (en) * | 2022-06-01 | 2023-06-14 | Федеральное государственное бюджетное учреждение высшего образования "Уральский государственный медицинский университет" Министерства здравоохранения Российской Федерации (ФГБОУ ВО УГМУ Минздрава России) | Device for shaping individualized augments replacing bone defects |
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