CN111281536A - Fibula-truncatable reconstructed jaw bone defect model and manufacturing method and application thereof - Google Patents
Fibula-truncatable reconstructed jaw bone defect model and manufacturing method and application thereof Download PDFInfo
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- CN111281536A CN111281536A CN202010258600.3A CN202010258600A CN111281536A CN 111281536 A CN111281536 A CN 111281536A CN 202010258600 A CN202010258600 A CN 202010258600A CN 111281536 A CN111281536 A CN 111281536A
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/17—Guides or aligning means for drills, mills, pins or wires
- A61B17/1732—Guides or aligning means for drills, mills, pins or wires for bone breaking devices
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00526—Methods of manufacturing
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
- A61B2034/101—Computer-aided simulation of surgical operations
- A61B2034/102—Modelling of surgical devices, implants or prosthesis
- A61B2034/104—Modelling the effect of the tool, e.g. the effect of an implanted prosthesis or for predicting the effect of ablation or burring
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
- A61B2034/101—Computer-aided simulation of surgical operations
- A61B2034/105—Modelling of the patient, e.g. for ligaments or bones
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
- A61B2034/108—Computer aided selection or customisation of medical implants or cutting guides
Abstract
The invention discloses a jaw bone defect model capable of truncating fibula and reconstructing jaw bone, 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 diseased jaw bone by a reconstruction and simulated resection method, and printing the jaw bone defect model body and the fibula model body by a 3D printing technology to obtain the model, the application comprises the steps of manufacturing a fibula bone truncation and reconstruction composite guide plate required by fibula cutting for fibula cutting by utilizing the truncatable bone reconstruction jaw bone defect model, the fibula can be cut more accurately by the invention, so that the reconstructed jaw bone can better recover the facial appearance of a patient, is precisely suitable for alveolar crest fibula of jaw, and fibula repair of artificial tooth after operation, the osteotomy reconstruction composite plate can overcome the defect of secondary punching on the bone, the operation precision is improved.
Description
Technical Field
The invention relates to the field of oral, maxillofacial and head and neck surgery, in particular to a fibula-truncatable reconstructed jaw bone defect model 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 oral and maxillofacial surgeons in domestic at present carry out the operation according to the disease, wherein the steps of the oral and maxillofacial surgeons in most hospitals at home are that a diseased area is observed through CT (computed tomography) shot by a patient, a three-dimensional model is reconstructed through professional medical software, a corresponding operation scheme is formulated, and then normal bones in a human body are cut to reconstruct the jaw bone, and when the bones are selected, the fibula has sufficient bone mass and proper thickness, so that a good foundation can be provided 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.
Present fibula is rebuild jaw model and is a whole, seamless fixed model, because of it cuts the difficulty, in the fibula is rebuild jaw defect model that 3D printed, it shifts to the fibula to cut the bone baffle with the rebuild titanium board nail way that the preflex takes shape hardly, the rotation angle that difficult realization fibula was rebuild is unanimous with design before the art, can only rely on doctor's experience to judge the rotation degree that the fibula was rebuild, consequently, the fibula that cuts down can not perfect the 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 fibula-truncatable reconstructed jaw bone defect model and 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 cut off fibula and rebuild jaw and lack the model, includes jaw model body and fibula model body, jaw model body and fibula model body form a complete can cut off fibula and rebuild jaw and lack the model through the spliced pole connection.
Furthermore, jaw model body, fibula model body and spliced pole adopt 3D to print the shaping.
Furthermore, the jaw bone model body, the fibula model body and the connecting column are made of medical resin materials.
A manufacturing method of a model capable of truncating fibula to reconstruct jaw bone defect 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 out the simulation model corresponding to the diseased jaw;
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 simulating to cut a fibula simulation model closest to the shape of the defective or diseased jaw;
s4, designing a connecting column on the cut jaw simulation model and the fibula simulation model, and connecting the cut jaw simulation model and the fibula simulation model into a whole to obtain a simulation model of a truncated fibula reconstruction jaw defect model;
s5, printing the simulation model of the cuttable fibula reconstruction jaw bone defect model by 3D printing to obtain the cuttable fibula reconstruction jaw bone defect model.
Further, in step S4, the connecting column has a diameter of 5mm and a height of 0.5 mm.
The application of a cuttable fibula reconstruction jaw bone defect model comprises the steps of utilizing the cuttable fibula reconstruction jaw bone defect model to pre-form a reconstruction titanium plate and manufacturing a cutting reconstruction composite guide plate required in fibula cutting, wherein the manufacturing method of the cutting reconstruction composite guide plate comprises the following steps:
a. pre-bending and forming the reconstructed titanium plate according to the shape and radian of the truncated fibula reconstructed jaw bone defect model;
b. transferring the nail path position of the reconstructed titanium plate which is pre-bent and formed on a cuttable fibula reconstruction jaw bone defect model, and then manufacturing titanium nail mounting holes on a jaw bone model body and a fibula model body according to the position of a titanium plate positioning hole;
c. the fibula model body is cut off along the connecting column, according to the shape and the cutting direction of each section of the fibula model body after cutting off, a fibula cutting guide plate which is attached to each section of the fibula model body is printed out through a 3D printing technology, and then the titanium nail mounting holes in each section of the fibula model body are transferred to the fibula cutting guide plate to obtain the fibula cutting reconstruction composite guide plate.
The invention has the beneficial effects that:
the invention changes the traditional integrated fibula reconstruction jaw bone defect model into a cuttable fibula reconstruction jaw bone defect model body, manufactures a titanium plate positioning hole on the fibula model body, transfers a nail channel on the fibula reconstruction composite guide plate according to the shape of the fibula model body and the position of the titanium plate positioning hole, manufactures the fibula reconstruction composite guide plate with the functions of fibula cutting and jaw bone reconstruction, and can better match the fibula cut by the fibula cutting reconstruction composite guide plate with each other and the jaw bone, so that the reconstructed jaw bone can obtain better shape and accurately match the jaw bone, which is beneficial to postoperative false tooth repair, furthermore, the fixing holes of the fibula cutting composite guide plate manufactured by the invention can be in one-to-one correspondence with the titanium plate positioning hole, when the fibula bone is cut off and reconstructed on the jaw bone, the titanium nail can be directly installed in the positioning hole left on the fibula bone when the fibula is cut off by the titanium plate positioning hole, 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 a schematic view of the prebending formation of the reconstructed titanium plate according to the present invention;
FIG. 3 is a schematic structural view of a fibula osteotomy reconstruction composite guide plate according to the invention;
fig. 4 is a schematic view of the connection between the fibula cutting and reconstruction composite guide plate and the fibula.
In the figure, 1-jaw model body, 2-fibula model body, 3-connecting column, 4-reconstructed titanium plate, 5-fibula osteotomy reconstruction composite guide plate, 6-fibula, 41-titanium plate positioning hole, 51-guide plate positioning hole and 52-guide cutting guide groove.
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 drawings only show the components related to the present invention rather than 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 jaw defect model for reconstructing fibula capable of being truncated is shown in attached figure 1 and comprises a jaw model body 1 and a fibula model body 2, wherein the jaw model body 1 and the fibula model body 2 are connected through a connecting column 3 to form a complete jaw defect model for reconstructing fibula capable of being truncated.
Further, the jaw bone model body 1, the fibula model body 2 and the connecting column 3 are formed by 3D printing.
Furthermore, the jaw bone model body 1, the fibula model body 2 and the connecting column 3 are made of medical resin materials.
A model for reconstructing jaw bone defect by truncating fibula is prepared by 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 out the simulation model corresponding to the diseased jaw;
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 simulating to cut a fibula simulation model closest to the shape of the defective or diseased jaw;
s4, designing a connecting column on the cut jaw simulation model and the fibula simulation model, and connecting the cut jaw simulation model and the fibula simulation model into a whole to obtain a simulation model of a truncated fibula reconstruction jaw defect model;
s5, printing the simulation model of the cuttable fibula reconstruction jaw bone defect model by 3D printing to obtain the cuttable fibula reconstruction jaw bone defect model.
Further, in step S4, the connecting column 3 has a diameter of 5mm and a height of 0.5 mm.
The application of the cuttable fibula reconstruction jaw bone defect model comprises the steps of utilizing the cuttable fibula reconstruction jaw bone defect model to bend in advance to reconstruct a titanium plate 4 and manufacturing a fibula reconstruction composite guide plate 5 required in fibula cutting, wherein the manufacturing method of the fibula reconstruction composite guide plate 5 comprises the following steps:
a. pre-bending and forming the reconstructed titanium plate 4 according to the shape and radian of the truncated fibula reconstructed jawbone defect model;
b. transferring the nail path position of the reconstructed titanium plate 4 which is pre-bent and formed on a cuttable fibula reconstruction jaw bone defect model, and further manufacturing titanium nail mounting holes on a jaw bone model body 1 and a fibula model body 2 according to the position of a titanium plate positioning hole 41;
c. the fibula model body 2 is cut off along the connecting column 3, a fibula cutting guide plate which is attached to each section of the fibula model body is printed out by using a 3D printing technology according to the shape and the cutting direction of each section of the fibula model body after cutting off, and then the titanium nail mounting holes in each section of the fibula model body are transferred to the fibula cutting guide plate to obtain the fibula cutting reconstruction composite guide plate 5.
The present invention is described in further detail below:
(1) before treating a patient with jaw bone defect or pathological changes, an assembled fibula reconstruction jaw bone defect model of the patient is manufactured according to the sequence of the steps S1-S6 in the embodiment, and then the prebending reconstruction titanium plate 4 and the fibula cutting reconstruction composite guide plate 5 are manufactured according to the steps a-c in the embodiment, wherein in the prebending process of the reconstruction titanium plate 4 on the cut fibula reconstruction jaw bone defect model, the reconstruction titanium plate 4 is tightly attached to the cut fibula reconstruction jaw bone defect model, and the curvature of the reconstruction titanium plate 4 is ensured to be the same as the radian of the assembled fibula reconstruction jaw bone defect model.
(2) In the implementation of the surgical treatment process, a double-group doctor performs a simultaneous operation, a doctor of a head side person exposes a jaw lesion position according to a preoperative plan, removes a jaw lesion, then fixes a pre-bent reconstructed titanium plate 4 on a healthy jaw bone left after the lesion is removed through a titanium nail, please refer to the attached drawing-4, the doctor of a leg side person cuts the calf muscle of a patient to expose a fibula 6, finds a position 6-8cm away from an ankle joint as a starting point, selects a fibula 6 position in the direction close to the heart end to prepare a vascularized fibula flap, then puts a sterilized fibula reconstruction composite guide plate 5 into a cut, attaches an arc surface of the fibula reconstruction composite guide plate 5 to the fibula 6, prepares a nail path through a titanium nail-punched drill, fixes the fibula reconstruction composite guide plate 5 on a section of a fibula 6 through a titanium nail after the nail path is prepared, cut the direction of compound baffle 5's direction cutting sword groove 52 according to the fibula and cut the cutting to fibula 6, obtain the fibula section the same and the incision direction unanimity with the 2 shapes of fibula model body, the fibula cuts good back, take out the titanium nail, treat that the operation district is rebuild to the side of the head and prepare the back, carry out fibula blood vessel pedicle of broken, hand over to the operation district of side of the head, the fibula section that will cut well splices with jaw according to the incision direction, and be fixed in the reconstruction fibula section that will splice and already fix on remaining jaw's shaping reconstruction titanium board 4.
It should be noted that, in the above embodiment, in the process of fixing the fibula reconstruction section, since the guide plate positioning hole 51 of the fibula reconstruction composite guide plate 5 of the present invention is shifted from the prebent-formed reconstruction titanium plate 4, when the fibula section is fixed on the reconstruction titanium plate 4 by using a titanium nail, the titanium nail is only needed to be screwed into the nail path prepared when the fibula is cut, thereby overcoming the drawback of secondary drilling on the fibula, not only improving the accuracy of the jawbone reconstruction operation, but also reducing the jawbone reconstruction operation time, meanwhile, since the cutting edge direction of each fibula section is cut according to the cutting edge direction of the guide cutting knife slot 52 of the fibula reconstruction composite guide plate 5, and the cutting edge direction of the fibula reconstruction composite guide plate 5 is designed according to the cutting edge direction of the fibula model 2, each fibula section can be perfectly matched with each other according to the cutting edge, 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.
As will be further explained in the above embodiments, in the process of manufacturing the fibula osteotomy reconstruction composite guide plate 5, because the diameter of the connecting column 3 is 5mm and the height is 0.5mm, when the fibula is cut by the fibula cutting and reconstructing composite guide plate 5, the loss amount of the fibula 6 is basically the same as the cutting loss amount of the connecting column 3, thereby ensuring that the cut fibula section can be accurately matched with the jaw bone, ensuring the accuracy of jaw bone reconstruction, and furthermore, can cut through 3 fixed connection of spliced pole between the jaw model body 1 and the fibula model body 2 of fibula reconstruction jaw bone defect model, do not take place relative rocking between jaw model body 1 and the fibula model body 2, can be better let rebuild titanium plate 4 and can cut the fibula and rebuild jaw bone defect model and go up the preflex shaping, this design concept is ingenious, can make things convenient for the preparation fibula to cut bone and rebuild compound baffle 5, can increase the assembly precision of rebuilding titanium plate 4 again.
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 (6)
1. The utility model provides a can cut off fibula and rebuild jaw and lack model, includes jaw model body (1) and fibula model body (2), its characterized in that, jaw model body (1) and fibula model body (2) are connected through spliced pole (3) and are formed a complete can cut off fibula and rebuild jaw and lack model.
2. The model of claim 1, wherein the jaw bone model body (1), the fibula model body (2) and the connecting column (3) are formed by 3D printing.
3. The model of claim 1, wherein the model body (1), the model body (2) and the connecting column (3) are made of medical resin.
4. A manufacturing method of a model capable of truncating fibula to reconstruct jaw bone defect 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 out the simulation model corresponding to the diseased jaw;
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 simulating to cut a fibula simulation model closest to the shape of the defective or diseased jaw;
s4, designing a connecting column on the cut jaw simulation model and the fibula simulation model, and connecting the cut jaw simulation model and the fibula simulation model into a whole to obtain a simulation model of a truncated fibula reconstruction jaw defect model;
s5, printing the simulation model of the cuttable fibula reconstruction jaw bone defect model by 3D printing to obtain the cuttable fibula reconstruction jaw bone defect model.
5. The method for preparing a model of a defect in a fibula-reconstructive jaw bone as claimed in claim 4, wherein the connecting column has a diameter of 5mm and a height of 0.5mm in step S4.
6. The application of the fibula-truncatable reconstruction jaw bone defect model comprises the steps of utilizing the fibula-truncatable reconstruction jaw bone defect model to pre-form a reconstruction titanium plate (4) and manufacturing a fibula-truncatable reconstruction composite guide plate (5) required in fibula cutting, wherein the manufacturing method of the fibula-truncatable reconstruction composite guide plate (5) comprises the following steps:
a. pre-bending and forming the reconstructed titanium plate (4) according to the shape and radian of the truncated fibula reconstructed jawbone defect model;
b. transferring the nail path position of the prebending-formed reconstructed titanium plate (4) to a cuttable fibula reconstructed jaw bone defect model, and further manufacturing titanium nail mounting holes on a jaw bone model body (1) and a fibula model body (2) according to the position of a titanium plate positioning hole (41);
c. the fibula model body (2) is cut off along the connecting column (3), according to the shape and the cutting direction of each section of the fibula model body after cutting off, a fibula cutting guide plate which is attached to each section of the fibula model body is printed out by using a 3D printing technology, and then the titanium nail mounting holes on each section of the fibula model body are transferred to the fibula cutting guide plate, so that the fibula cutting reconstruction composite guide plate (5) is obtained.
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Cited By (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN112451070A (en) * | 2020-10-15 | 2021-03-09 | 中国医学科学院北京协和医院 | Free fibula reconstruction jaw bone system based on HoloLens |
| CN112842530A (en) * | 2021-01-29 | 2021-05-28 | 北京大学口腔医学院 | Method for manufacturing jaw bone operation guide plate and repairing implant false tooth in same period of reconstruction |
| CN113081260A (en) * | 2021-04-19 | 2021-07-09 | 北京大学口腔医学院 | Autologous bone block trimming process and application thereof in tooth implantation |
| CN113855234A (en) * | 2021-11-05 | 2021-12-31 | 黄睿明 | Fibula automatic reconstruction method for repairing mandibular bone defect |
-
2020
- 2020-04-03 CN CN202010258600.3A patent/CN111281536A/en active Pending
Cited By (5)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN112451070A (en) * | 2020-10-15 | 2021-03-09 | 中国医学科学院北京协和医院 | Free fibula reconstruction jaw bone system based on HoloLens |
| CN112842530A (en) * | 2021-01-29 | 2021-05-28 | 北京大学口腔医学院 | Method for manufacturing jaw bone operation guide plate and repairing implant false tooth in same period of reconstruction |
| CN113081260A (en) * | 2021-04-19 | 2021-07-09 | 北京大学口腔医学院 | Autologous bone block trimming process and application thereof in tooth implantation |
| CN113855234A (en) * | 2021-11-05 | 2021-12-31 | 黄睿明 | Fibula automatic reconstruction method for repairing mandibular bone defect |
| CN113855234B (en) * | 2021-11-05 | 2024-02-23 | 黄睿明 | Fibula automatic reconstruction method for repairing mandible defect |
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