CN110801283A - Fibula-assembled reconstructed jaw bone defect model and manufacturing method and application thereof - Google Patents
Fibula-assembled reconstructed jaw bone defect model and manufacturing method and application thereof Download PDFInfo
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- CN110801283A CN110801283A CN201911272994.1A CN201911272994A CN110801283A CN 110801283 A CN110801283 A CN 110801283A CN 201911272994 A CN201911272994 A CN 201911272994A CN 110801283 A CN110801283 A CN 110801283A
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Abstract
The invention discloses a jaw bone defect model capable of being assembled with fibula reconstruction, a manufacturing method and application thereof, wherein the model comprises a jaw bone defect model body and a fibula model body, the manufacturing method comprises the steps of constructing a complete jaw bone simulation model and a fibula simulation model by utilizing CT scanning and medical software, designing a fibula section which is most suitable for reconstructing a diseased jaw bone by a reconstruction and simulated cutting method, adjusting a rotating angle, printing the jaw bone defect model body and the fibula model body by a 3D printing technology, and finally assembling a connecting bulge and a connecting groove on the jaw bone defect model body and the fibula model body to obtain the jaw bone defect model, the application comprises the steps of manufacturing a fibula bone cutting and reconstruction composite guide plate required by fibula cutting, and the fibula can be cut more accurately by the jaw bone so that the reconstructed jaw bone can better recover the facial appearance of a patient and accurately fit a jaw ridge, the artificial tooth is repaired better after the operation, the defect of secondary punching on the fibula can be overcome by the osteotomy reconstruction composite guide plate, and the operation precision is improved.
Description
Technical Field
The invention relates to the field of oral maxillofacial-head and neck surgery, in particular to a jaw bone defect model capable of being assembled with fibula reconstruction and a manufacturing method and application thereof.
Background
In recent years, jaw bone defects and malformed cases caused by factors such as growth and development problems, traffic accidents, facial tumors and the like are in a rising trend, and most of stomatologists in domestic hospitals carry out the operation at present, wherein the steps of carrying out the operation comprise observing a diseased region through CT (computed tomography) shot by a patient, reconstructing a three-dimensional model through professional medical software, making a corresponding operation scheme, and then cutting normal bones in a human body to reconstruct jaw bones, and when the bones are selected, fibulas have sufficient bone mass and proper thickness and can provide a good foundation for later-stage planting repair; the fibula has double blood supplies and is easy to survive; the anatomical positions of the fibular artery and vein are constant, thick in diameter and easy to be anastomosed, so that the fibula becomes the preferred bone for reconstructing the jaw bone.
At present fibula rebuilds jaw model is an integral fixation model, but because of it can't realize assembly and its immobility, when fibula cutting guide plate according to utilizing fixed model to make carries out the fibula cutting, the fibula section of intercepting is rebuilding the jaw defect in-process, can't realize rotation angle and design unanimous before the art, can only rely on doctor's experience to judge the angle that the fibula was rebuild, consequently, the fibula that cuts down can not perfect matching when rebuilding jaw, thereby unable better adaptation is to jaw alveolar ridge, the prosthetic degree of difficulty of postoperative artificial tooth has been increaseed.
Furthermore, in the process of cutting the fibula, in order to ensure the accuracy of the fibula cutting, the fibula cutting guide plate needs to be fixed on the fibula, the bone cutting guide plate is generally positioned by a positioning hole on the guide plate and a screw and a fibula, but the existing bone cutting guide plate has a great disadvantage that as shown in the attached drawing-3, when the fibula is cut off and reconstructed on a jawbone, a titanium plate is required to fix the position, when the fibula position is fixed by the titanium plate, the fixation is realized by the positioning hole and the titanium nail on the titanium plate, because the positioning holes on the osteotomy guide plate are randomly arranged and can not correspond to the positioning holes on the titanium plate, at this moment just need be at fibula reconstruction jaw in-process, carry out the secondary and punch and fix in the fibula section and rebuild on the titanium board, the secondary of fibula punches not only to increase jaw and rebuild the operation time, but also reduced jaw and rebuild the precision of operation.
Disclosure of Invention
The invention aims to overcome the defects of the prior art and provides a jaw bone defect model capable of being assembled with fibula reconstruction, a manufacturing method and application thereof so as to solve the problems in the technical background.
The purpose of the invention is realized by the following technical scheme:
the utility model provides a can assemble fibula and rebuild jaw bone defect model, includes the jaw bone defect model body and a plurality of fibula model bodies that can assemble each other, can splice into a complete can assemble fibula and rebuild jaw bone model with the jaw bone defect model body after a plurality of fibula model bodies assemble each other.
Further, jaw is defected the model body and is included first jaw and defected the model body (102) of second jaw, a plurality of fibula model bodies that can assemble each other include first fibula model body, second fibula model body and third fibula model body, be equipped with respectively on first fibula model body, second fibula model body, third fibula model body, first jaw and defected the model body and the second jaw and connect protruding and connecting the recess, first fibula model body, second fibula model body, third fibula model body, first jaw and defected the model body and second jaw are passed through connect protruding and the clearance fit between the recess splice into a complete can assemble fibula and rebuild jaw model.
Furthermore, the connecting protrusions and the connecting grooves are irregular polygonal column protrusions and polygonal grooves which are in clearance fit with each other.
Further, the jaw bone defect model body and the plurality of fibula model bodies which can be assembled with each other are formed by 3D printing.
Furthermore, the jaw bone defect model body and the fibula model bodies which can be assembled with each other are made of medical resin materials.
A method for manufacturing a fibula reconstruction jaw bone defect model comprises the following steps:
s1, performing head CT and double lower limb CTA (computed tomography angiography) examination on a patient with jaw bone lesion by using CT scanning equipment, and importing DICOM data of scanned iconography data into medical software to reconstruct a complete jaw bone simulation model and a fibula simulation model;
s2, performing simulated cutting on the diseased jaw part on the constructed complete jaw simulation model, determining the optimal cutting path, and cutting off the diseased jaw simulation model;
s3, replacing the removed diseased jaw simulation model with a fibula simulation model, selecting a proximal fibula section 6-8cm away from the ankle joint, adjusting the length and the angle, and cutting out a fibula simulation model section which is most similar to the shape of the defective or diseased jaw;
s4, designing connecting bulges and connecting grooves on the cut jaw simulation model and fibula simulation model segments respectively;
s5, respectively printing the jaw bone simulation model and the fibula simulation model with the designed connecting protrusions and connecting grooves in a segmented mode through 3D printing to obtain a jaw bone defect model body and a fibula model body;
and S6, assembling the printed jaw bone defect model body and the fibula model body through the connecting protrusions and the connecting grooves to obtain an assembled fibula reconstruction jaw bone defect model.
6. The application of the assembled fibula reconstruction jaw bone defect model is characterized in that the application comprises the steps of utilizing the assembled fibula reconstruction jaw bone defect model to bend a formed titanium plate in advance and manufacturing an osteotomy reconstruction composite guide plate required in fibula cutting, and the manufacturing method of the osteotomy reconstruction composite guide plate comprises the following steps:
1) pre-bending and forming the titanium plate according to the shape and the curvature of the jaw bone defect model capable of being assembled with the fibula reconstruction model;
2) transferring the nail path position of the pre-bent titanium plate to an assembled fibula reconstruction jaw bone defect model, and manufacturing titanium nail mounting holes on a first fibula model body, a second fibula model body, a third fibula model body and a jaw bone defect model body according to the position of a titanium plate positioning hole;
3) according to the shape of the first fibula model body, the second fibula model body and the third fibula model body, the cutting direction and the position of the titanium nail mounting hole in the fibula model body, the 3D printing technology is utilized to print out the osteotomy reconstruction composite guide plate which is jointed with the first fibula model body, the second fibula model body and the third fibula model body.
The invention has the beneficial effects that:
the invention changes the traditional integrated fibula reconstruction jaw bone defect model into an assembled fibula reconstruction jaw bone defect model body, manufactures titanium plate positioning holes on the fibula model body, prints out a fibula osteotomy reconstruction composite guide plate with functions of jawbone osteotomy and reconstruction according to the shape of the assembled fibula model body and the position of the titanium plate positioning holes, and can better match the fibula intercepted by the fibula osteotomy reconstruction composite guide plate with the jawbone, so that the reconstructed jawbone can obtain better shape, is accurately matched with the jaw and is beneficial to the false tooth repair after operation, furthermore, the fixing holes of the fibula osteotomy composite guide plate manufactured by the invention can be in one-to-one correspondence with the titanium plate positioning holes, when the fibula is cut off and reconstructed on the jawbone, the titanium nails can be directly installed in the positioning holes left on the fibula when the fibula is cut through the titanium plate positioning holes, overcome the drawback that punches on the fibula for the second time when jaw is rebuild, not only improved jaw and rebuild the precision of operation, but also reduced jaw and rebuild the operation time.
Drawings
FIG. 1 is a schematic structural view of the present invention;
FIG. 2 is an exploded view of a component of the present invention;
FIG. 3 is a schematic view of the connection between a jaw bone defect model body and a fibula model body and a titanium plate according to the present invention;
FIG. 4 is a schematic structural view of a osteotomy reconstruction composite guide plate according to the present invention;
fig. 5 is a schematic view of the connection between the osteotomy reconstruction composite guide plate and the fibula.
In the figure, 1-jaw bone defect model body, 2-fibula model body, 3-connecting bulge, 4-connecting groove, 5-osteotomy reconstruction composite guide plate, 6-titanium plate, 7-titanium plate positioning hole, 8-fibula, 9-positioning hole, 10-guiding cutting groove, 101-first jaw bone defect model body, 102-second jaw bone defect model body, 201-first fibula model body, 202-second fibula model body and 203-third fibula model body.
Detailed Description
The embodiments of the present invention are described below with reference to specific embodiments, and other advantages and effects of the present invention will be easily understood by those skilled in the art from the disclosure of the present specification. The invention is capable of other and different embodiments and of being practiced or of being carried out in various ways, and its several details are capable of modification in various respects, all without departing from the spirit and scope of the present invention. It is to be noted that the features in the following embodiments and examples may be combined with each other without conflict.
It should be noted that the drawings provided in the following embodiments are only for illustrating the basic idea of the present invention, and the components related to the present invention are only shown in the drawings rather than drawn according to the number, shape and size of the components in actual implementation, and the type, quantity and proportion of the components in actual implementation may be changed freely, and the layout of the components may be more complicated.
Example (b):
a fibula reconstruction jaw bone defect model capable of being assembled, please refer to fig. 1-fig. 2, which comprises a jaw bone defect model body 1 and a plurality of fibula model bodies 2 capable of being assembled with each other, wherein the plurality of fibula model bodies 2 can be assembled with the jaw bone defect model body 1 to form a complete assembled fibula reconstruction jaw bone model.
Further, the jaw bone defect model body 1 comprises a first jaw bone defect model body 101 and a second jaw bone defect model body 102, the plurality of mutually-assembled fibula model bodies 2 comprise a first fibula model body 201, a second fibula model body 202 and a third fibula model body 203, the first fibula model body 201, the second fibula model body 202, the third fibula model body 203, the first jaw bone defect model body 101 and the second jaw bone defect model body 102 are respectively provided with a connecting protrusion 3 and a connecting groove 4, and the first fibula model body 201, the second fibula model body 202, the third fibula model body 203, the first jaw bone defect model body 101 and the second jaw bone defect model body 102 are spliced into a complete assembled fibula reconstructed jaw bone model through clearance fit between the connecting protrusion 3 and the connecting groove 4.
Furthermore, the connecting protrusions 4 and the connecting grooves 4 are irregular polygonal column protrusions and polygonal grooves which are in clearance fit with each other, so that the contact area of the connecting part is larger, and the connection between the model bodies is more stable.
Further, the jaw bone defect model body 1 and the plurality of mutually assembled fibula model bodies 2 are formed by 3D printing.
Further, the jaw bone defect model body 1 and the plurality of fibula model bodies 2 which can be assembled with each other are made of medical resin materials.
A method for manufacturing a fibula reconstruction jaw bone defect model comprises the following steps:
s1, performing head CT and double lower limb CTA (computed tomography angiography) examination on a patient with jaw bone lesion by using CT scanning equipment, and importing DICOM data of scanned iconography data into medical software to reconstruct a complete jaw bone simulation model and a fibula simulation model;
s2, performing simulated cutting on the diseased jaw part on the constructed complete jaw simulation model, determining the optimal cutting path, and cutting off the diseased jaw simulation model;
s3, replacing the removed diseased jaw simulation model with a fibula simulation model, selecting a proximal fibula section 6-8cm away from the ankle joint, adjusting the length and the angle, and cutting out a fibula simulation model section which is closest to the lost or diseased jaw shape;
s4, designing connecting bulges and connecting grooves on the cut jaw simulation model and fibula simulation model segments respectively;
s5, respectively printing a jaw bone simulation model and a fibula simulation model with designed connecting bulges and connecting grooves in a segmented mode through 3D printing to obtain a jaw bone defect model body 1 and a fibula model body 2;
and S6, assembling the printed jaw bone defect model body 1 and the fibula model body 2 through the connecting protrusion 3 and the connecting groove 4 to obtain an assembled fibula reconstruction jaw bone defect model.
The application of the assembled fibula reconstruction jaw bone defect model specifically comprises the steps of utilizing the assembled fibula reconstruction jaw bone defect model to bend a formed titanium plate 6 in advance and manufacturing a bone cutting reconstruction composite guide plate 5 required in fibula cutting, wherein the manufacturing method of the bone cutting reconstruction composite guide plate 5 comprises the following steps:
1) pre-bending and forming the titanium plate 6 according to the shape and the curvature of the jaw bone defect model capable of being assembled with the fibula reconstruction model;
2) transferring the nail path position of the pre-bent titanium plate 6 to an assembled fibula reconstruction jaw bone defect model, and then manufacturing titanium nail mounting holes on the first fibula model body 201, the second fibula model body 202, the third fibula model body 203 and the jaw bone defect model body 1 according to the position of the titanium plate positioning hole 7;
3) and according to the shapes and the cutting directions of the first fibula model body 201, the second fibula model body 202 and the third fibula model body 203 and the positions of the titanium nail mounting holes in the fibula model body, the osteotomy reconstruction composite guide plate 5 which is attached to the first fibula model body 201, the second fibula model body 202 and the third fibula model body 203 is printed by using a 3D printing technology.
The present invention is described in further detail below:
before treating a patient with jaw bone defect or lesion, a fibula reconstruction jaw bone defect model which can be assembled and used for the patient is manufactured according to the sequence of the steps S1-S6 in the embodiment, then, a pre-bending titanium plate 6 and a fibula cutting reconstruction composite guide plate 5 are manufactured according to the steps 1) -2) in the embodiment, in the process of performing operation treatment, a double-group doctor performs simultaneous operation, a doctor of a head side person exposes the jaw bone lesion position according to preoperative planning, the jaw bone lesion position is cut off, then, the pre-bending titanium plate 6 is fixed on a healthy jaw bone left after the lesion position is cut off through a titanium nail, please refer to the attached drawing-5, the doctor of a leg side person cuts the calf muscle of the patient, exposes the fibula 8, finds the position 6-8cm away from an ankle joint as a starting point, and selects the position 8 in the proximal direction, preparing a vascularized fibula flap, putting the sterilized osteotomy reconstruction composite guide plate 5 into a cut, attaching the arc-shaped surface of the osteotomy reconstruction composite guide plate 5 to a fibula 8, preparing a nail channel by a titanium nail punching drill after the attachment, fixing the osteotomy reconstruction composite guide plate 5 on the fibula 8 section to be intercepted by using a titanium nail after the nail channel is prepared, cutting the fibula according to the direction of a guide cutting knife groove 10 of the osteotomy reconstruction composite guide plate 5 to obtain a fibula section which has the same shape as the first fibula model body 201, the second fibula model body 202 and the third fibula model body 203 and has the same cutting direction, taking out the titanium nail after the fibula is cut, performing fibula flap blood vessel pedicle cutting after a head side reconstruction operation area is prepared, handing over to the head side operation area, splicing the cut fibula section with a jaw bone according to the cutting direction, fixing the spliced and reconstructed fibula section on a titanium plate 6 which is fixed on a remaining jaw bone, in the fixing process, the positions of the positioning holes 9 of the osteotomy reconstruction composite guide plate 5 are designed and printed according to the positions of the titanium plate positioning holes 7 on the first fibula model body 201, the second fibula model body 202 and the third fibula model body 203, so that when the fibula section is fixed on the titanium plate 6 by using titanium nails, only a titanium nail is screwed into a nail path prepared when the fibula is cut, the defect of secondary punching on the fibula is overcome, the jaw bone reconstruction surgery precision is improved, the jaw bone reconstruction surgery time is reduced, meanwhile, the knife edge direction of each fibula section is cut according to the knife edge direction of the guide cutting knife slot 10 of the osteotomy reconstruction composite guide plate 5, and the knife edge direction of the osteotomy reconstruction composite guide plate is designed according to the knife edge directions of the first fibula model body 201, the second fibula model body 202 and the third fibula model body 203, therefore, each fibula section can be perfectly matched with each other according to the incision, so that the reconstructed jaw bone can be more accurately matched with the alveolar ridge of the jaw, the artificial tooth repair can be better carried out after the operation, and the appearance and the jaw bone function of a patient can be better recovered.
The above-mentioned embodiments only express the specific embodiments of the present invention, and the description thereof is more specific and detailed, but not construed as limiting the scope of the present invention. It should be noted that, for a person skilled in the art, several variations and modifications can be made without departing from the inventive concept, which falls within the scope of the present invention.
Claims (7)
1. The utility model provides a can assemble fibula and rebuild jaw bone defect model, includes jaw bone defect model body (1) and a plurality of fibula model body (2) that can assemble each other, its characterized in that, a complete fibula of can assembling rebuild jaw bone model can be spliced into with jaw bone defect model body (1) after a plurality of fibula model bodies (2) assemble each other.
2. A jaw bone defect model capable of being assembled with fibula reconstruction according to claim 1, wherein the jaw bone defect model body (1) comprises a first jaw bone defect model body (101) and a second jaw bone defect model body (102), the plurality of mutually assembled fibula model bodies (2) comprise a first fibula model body (201), a second fibula model body (202) and a third fibula model body (203), the first fibula model body (201), the second fibula model body (202), the third fibula model body (203), the first jaw bone defect model body (101) and the second jaw bone defect model body (102) are respectively provided with a connecting protrusion (3) and a connecting groove (4), and the first fibula model body (201), the second fibula model body (202), the third fibula model body (203), the first jaw bone defect model body (101) and the second jaw bone defect model body (102) pass through the connecting protrusion (3) and the connecting groove (4) The gap fit of the jaw plates is spliced into a complete fibula reconstruction jaw bone model which can be assembled.
3. A fitted fibula reconstruction jaw bone defect model according to claim 2, characterized in that the connecting protrusions (4) and connecting grooves (4) are irregular polygonal column protrusions and polygonal grooves which are clearance-fitted with each other.
4. A fittable fibula reconstruction jaw bone defect model according to claim 1, characterized in that said jaw bone defect model body (1) and a plurality of mutually fittable fibula model bodies (2) are shaped by 3D printing.
5. The assembled fibula reconstruction jaw bone defect model according to claim 1, wherein the jaw bone defect model body (1) and the plurality of mutually assembled fibula model bodies (2) are made of medical resin.
6. A method for manufacturing a jaw defect model capable of being assembled with fibula reconstruction is characterized by comprising the following steps:
s1, performing head CT and double lower limb CTA (computed tomography angiography) examination on a patient with jaw bone lesion by using CT scanning equipment, and importing DICOM data of scanned iconography data into medical software to reconstruct a complete jaw bone simulation model and a fibula simulation model;
s2, performing simulated cutting on the diseased jaw part on the constructed complete jaw simulation model, determining the optimal cutting path, and cutting off the diseased jaw simulation model;
s3, replacing the removed diseased jaw simulation model with a fibula simulation model, selecting a proximal fibula section 6-8cm away from the ankle joint, adjusting the length and the angle, and cutting out a fibula simulation model section which is most similar to the shape of the defective or diseased jaw;
s4, designing connecting bulges and connecting grooves on the cut jaw simulation model and fibula simulation model segments respectively;
s5, respectively printing a jaw bone simulation model and a fibula simulation model with designed connecting bulges and connecting grooves in a segmented mode through 3D printing to obtain a jaw bone defect model body (1) and a fibula model body (2);
and S6, assembling the printed jaw bone defect model body (1) and the fibula model body (2) through the connecting protrusion (3) and the connecting groove (4) to obtain an assembled fibula reconstruction jaw bone defect model.
7. The application of the assembled fibula reconstruction jaw bone defect model is characterized in that the application comprises the steps of utilizing the assembled fibula reconstruction jaw bone defect model to bend a formed titanium plate (6) in advance and manufacturing a bone cutting reconstruction composite guide plate (5) required in fibula cutting, and the manufacturing method of the bone cutting reconstruction composite guide plate (5) comprises the following steps:
1) pre-bending and forming the titanium plate (6) according to the shape and the curvature of the jaw bone defect model capable of being assembled with the fibula reconstruction model;
2) transferring the nail path position of the pre-bent titanium plate to an assembled fibula reconstruction jaw bone defect model, and further manufacturing titanium nail mounting holes on a first fibula model body (201), a second fibula model body (202), a third fibula model body (203) and a jaw bone defect model body (1) according to the position of a titanium plate positioning hole (7);
3) according to the shape and the cutting direction of the first fibula model body (201), the second fibula model body (202) and the third fibula model body (203) and the position of a titanium nail mounting hole in the fibula model body, the osteotomy reconstruction composite guide plate (5) jointed with the first fibula model body (201), the second fibula model body (202) and the third fibula model body (203) is printed by using a 3D printing technology.
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Cited By (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN111281536A (en) * | 2020-04-03 | 2020-06-16 | 中国医学科学院北京协和医院 | Fibula-truncatable reconstructed jaw bone defect model and manufacturing method and application thereof |
| CN111481281A (en) * | 2020-04-21 | 2020-08-04 | 上海交通大学医学院附属第九人民医院 | Method for reconstructing mandible by internally fixed fibula |
| CN113712709A (en) * | 2021-08-23 | 2021-11-30 | 佛山市安齿生物科技有限公司 | Artificial temporal joint preparation facilities |
| CN114569260A (en) * | 2020-11-18 | 2022-06-03 | 中山大学附属口腔医院 | Guiding plate for positioning after maxillary osteotomy |
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2019
- 2019-12-12 CN CN201911272994.1A patent/CN110801283A/en active Pending
Cited By (5)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN111281536A (en) * | 2020-04-03 | 2020-06-16 | 中国医学科学院北京协和医院 | Fibula-truncatable reconstructed jaw bone defect model and manufacturing method and application thereof |
| CN111481281A (en) * | 2020-04-21 | 2020-08-04 | 上海交通大学医学院附属第九人民医院 | Method for reconstructing mandible by internally fixed fibula |
| CN111481281B (en) * | 2020-04-21 | 2022-12-27 | 上海交通大学医学院附属第九人民医院 | Preparation method of internal fixing device for fibula reconstruction mandible |
| CN114569260A (en) * | 2020-11-18 | 2022-06-03 | 中山大学附属口腔医院 | Guiding plate for positioning after maxillary osteotomy |
| CN113712709A (en) * | 2021-08-23 | 2021-11-30 | 佛山市安齿生物科技有限公司 | Artificial temporal joint preparation facilities |
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