CN113081260B - Autologous bone piece trimming process and application thereof in tooth planting - Google Patents
Autologous bone piece trimming process and application thereof in tooth planting Download PDFInfo
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- CN113081260B CN113081260B CN202110417123.5A CN202110417123A CN113081260B CN 113081260 B CN113081260 B CN 113081260B CN 202110417123 A CN202110417123 A CN 202110417123A CN 113081260 B CN113081260 B CN 113081260B
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- 210000000988 bone and bone Anatomy 0.000 title claims abstract description 238
- 238000009966 trimming Methods 0.000 title claims abstract description 58
- 238000000034 method Methods 0.000 title claims abstract description 13
- 238000000605 extraction Methods 0.000 claims description 13
- 239000007943 implant Substances 0.000 claims description 9
- 238000004088 simulation Methods 0.000 claims description 9
- 230000001174 ascending effect Effects 0.000 claims description 4
- 238000010146 3D printing Methods 0.000 claims description 3
- 239000008280 blood Substances 0.000 claims description 3
- 210000004369 blood Anatomy 0.000 claims description 3
- 239000004053 dental implant Substances 0.000 claims description 3
- 238000007730 finishing process Methods 0.000 claims description 3
- 210000000214 mouth Anatomy 0.000 claims description 3
- 210000005036 nerve Anatomy 0.000 claims description 3
- 238000002360 preparation method Methods 0.000 claims 2
- 238000007408 cone-beam computed tomography Methods 0.000 claims 1
- 208000006735 Periostitis Diseases 0.000 abstract description 3
- 210000003460 periosteum Anatomy 0.000 abstract description 3
- 238000007493 shaping process Methods 0.000 abstract description 2
- 210000001847 jaw Anatomy 0.000 description 6
- 238000010079 rubber tapping Methods 0.000 description 6
- 238000002513 implantation Methods 0.000 description 4
- 208000027418 Wounds and injury Diseases 0.000 description 3
- 208000008312 Tooth Loss Diseases 0.000 description 2
- 230000007547 defect Effects 0.000 description 2
- 208000014674 injury Diseases 0.000 description 2
- 230000008733 trauma Effects 0.000 description 2
- 208000024216 Periapical disease Diseases 0.000 description 1
- 238000010521 absorption reaction Methods 0.000 description 1
- 230000009286 beneficial effect Effects 0.000 description 1
- 230000000694 effects Effects 0.000 description 1
- 210000000887 face Anatomy 0.000 description 1
- PCHJSUWPFVWCPO-UHFFFAOYSA-N gold Chemical compound [Au] PCHJSUWPFVWCPO-UHFFFAOYSA-N 0.000 description 1
- 238000001727 in vivo Methods 0.000 description 1
- 230000007774 longterm Effects 0.000 description 1
- 230000004048 modification Effects 0.000 description 1
- 238000012986 modification Methods 0.000 description 1
- 230000000399 orthopedic effect Effects 0.000 description 1
- 230000002188 osteogenic effect Effects 0.000 description 1
- 210000003254 palate Anatomy 0.000 description 1
- 208000028169 periodontal disease Diseases 0.000 description 1
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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
-
- 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
-
- 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
- A61B17/1739—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body
- A61B17/176—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body for the jaw
-
- 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
- A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
-
- 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
- A61B17/1703—Guides or aligning means for drills, mills, pins or wires using imaging means, e.g. by X-rays
-
- 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
-
- 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
- A61B2034/107—Visualisation of planned trajectories or target regions
-
- 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
-
- 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
- A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
- A61B2034/2046—Tracking techniques
- A61B2034/2065—Tracking using image or pattern recognition
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- Health & Medical Sciences (AREA)
- Surgery (AREA)
- Life Sciences & Earth Sciences (AREA)
- Engineering & Computer Science (AREA)
- Medical Informatics (AREA)
- General Health & Medical Sciences (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- Veterinary Medicine (AREA)
- Public Health (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Dentistry (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Robotics (AREA)
- Prostheses (AREA)
Abstract
The invention relates to an orthopaedics shaping method, in particular to an autologous bone block trimming process and application thereof in tooth planting, comprising the steps of establishing a model, and reconstructing a jaw model by utilizing a medical image control system; designing a prosthesis, and designing the position and the shape of an ideal prosthesis of an affected part; position adjustment and determination, selecting an optimal bone taking site, designing a bone taking guide plate and a trimming guide plate, intercepting a bone block in a bone supply area, putting the bone block into the trimming guide plate for trimming, and putting the trimmed bone block into a bone receiving area to finally receive a bone part; and fixing the trimmed bone block on the final bone receiving part, making periosteum incision, reducing tension, suturing and closing the wound. The building model can measure and design the matched prosthesis without implementation on a patient, and simultaneously, the optimal size and shape of the prosthesis can be accurately obtained, the building of the bone block model is guided according to the shape and size of the prosthesis, the safe and optimal bone taking site is selected according to the principle of carrying out minimum trimming on the taken bone block according to the requirement, and the redundant healthy bones are not damaged.
Description
Technical Field
The invention relates to an orthopedic shaping method, in particular to an autologous bone piece trimming process and application thereof in tooth implantation.
Background
Tooth loss, particularly tooth loss caused by dental trauma, periodontal disease, periapical disease and the like, is usually accompanied by mass absorption of alveolar bone of the site to be planted, and sufficient bone mass is important for the implantation position and long-term stability of the implant, so that bone increment operation is often required before the implantation repair treatment due to insufficient bone mass of the site to be planted.
Autologous bone is considered as the gold standard of bone grafts, and the bone supply regions of autologous bone include intraoral and extraoral supply regions, with the most common bone removal regions being the intraoral mandibular ascending branch and chin, and autologous massive bone grafting being an effective means of reconstruction of severe bone defects. The bone blocks to be implanted need to be suitable in size and shape with the bone blocks required by the bone receiving area and well fit with the bone faces of the bone receiving area, and how to obtain the bone blocks with proper size in the bone supplying area and how to trim the removed bone blocks is a difficult point of autologous blocky bone grafting. Too large bone pieces for removal of the bone region can cause unnecessary trauma, and insufficient amounts of removed bone can affect the osteogenic effect. The intraoperative trimming of the bone block often lacks reference, and the trimming efficiency of the bone block is low and the trimming effect is poor.
Disclosure of Invention
The invention aims to provide an autologous bone piece trimming process and application thereof in tooth planting so as to solve the problems in the prior art.
In order to achieve the above purpose, the present invention provides the following technical solutions:
An autologous bone piece finishing process comprising the steps of:
Firstly, establishing a model, namely importing preoperative oral cavity CBCT (cone beam CT) data into a medical image control system, and reconstructing a jaw model;
Designing a prosthesis, namely designing the position and the shape of an ideal prosthesis of the affected part according to the positions and the shapes of the adjacent teeth and the opposite jaw teeth of the affected part, and designing the size and the position of an implant according to the designed position and shape of the ideal prosthesis;
Step three, designing a bone block model, namely designing the size and the shape of a bone block as a bone block model according to the bone mass requirement around the implant and the aesthetic shape of the bone contour around the affected part;
Step four, position adjustment and determination, namely placing the designed bone block model in a bone supply area in a simulation system, adjusting the position of the bone block model, selecting an optimal bone taking site, and avoiding the tooth root and nerve blood tube bundle of surrounding adjacent teeth by at least 2mm;
wherein, the best selected bone taking site is a plurality of, one of which is selected as the final bone taking site;
Fifthly, designing a bone taking guide plate and a trimming guide plate, designing the bone taking guide plate according to the section of a bone block model at the final bone taking position, designing the trimming guide plate according to the designed bone taking guide plate and the simulated bone cutting of the bone block model, and combining the bone block shape required by the bone receiving area;
step six, the designed bone taking guide plate and the trimming guide plate are manufactured by 3D printing, bone blocks in a bone supply area are intercepted and placed into the trimming guide plate, the bone blocks are trimmed according to the form of the trimming guide plate, and the trimmed bone blocks are placed into the final bone receiving part of the bone receiving area;
and seventhly, fixing the bone block trimmed in the step six on a final bone receiving part, making periosteum incision, reducing tension, suturing and closing the wound.
As a further scheme of the invention: in the fourth step, when the optimal bone extraction site is selected, the bone block model is moved to a safe bone extraction area of the focus jawbone;
the optimal bone taking site is determined according to the shape or bone quantity of the required bone block, and commonly used bone taking sites are the mandibular ascending branch outer oblique line position, the mandibular chin position, the maxillary tuberosity position and the like.
As still further aspects of the invention: in the fourth step, when the final bone taking part is selected, the designed bone blocks to be implanted can be divided into a plurality of parts, the bone blocks required by each part are respectively moved into the jaw bone taking positions in the simulation system, the positions of the bone blocks of each part are adjusted, and the site needing to carry out the least trimming on the bone blocks to be taken out is selected as the final bone taking part.
As still further aspects of the invention: in the seventh step, each trimmed bone block is fixed at the final bone receiving position by 1-2 self-tapping screws.
An application of an autologous bone piece trimming process to dental implant, comprising the steps of the above embodiments, wherein the design of the bone extraction guide is to design four osteotomy planes according to a bone piece model at a final bone extraction site, and design the bone extraction guide according to the osteotomy planes;
the design of the trimming guide plate is to simulate osteotomies according to four osteotomies planes in a simulation system, and the trimming guide plate is designed for the osteotomies according to the shape of the osteotomies to be implanted according to the design.
As a further scheme of the invention: the middle part of the trimming guide plate can be provided with a plurality of bone cutting grooves, the cut bone blocks are divided into a plurality of parts according to the bone cutting grooves on the trimming guide plate, and the edges of the cut bone blocks are ground according to the edges of the trimming guide plate.
As still further aspects of the invention: the trimmed bone blocks can be divided into a plurality of parts by a plurality of bone cutting grooves of the trimming guide plate, each part of bone blocks is respectively placed in a bone receiving area of a focus according to the design, and each bone block is respectively fixed at the focus through 1-2 self-tapping screws.
Compared with the prior art, the invention has the beneficial effects that: the method has the advantages that the model is built, the matched prosthesis can be measured and designed according to the actual bone defect receiving area without implementation on a patient, meanwhile, the optimal size and shape of the prosthesis can be accurately obtained, the building of the bone block model is guided according to the shape and size of the prosthesis, the safe and optimal bone taking site is selected according to the principle that the minimum trimming is carried out on the taken bone block, redundant healthy bones are not damaged, the trimming of the bone block is guided by utilizing the bone taking guide plate and the trimming guide plate, self-implantation of the bone is carried out, and the stability is greatly improved through screw fixation.
Detailed Description
The technical solutions of the present invention will be clearly and completely described in conjunction with the embodiments of the present invention, and it is apparent that the described embodiments are only some embodiments of the present invention, but not all embodiments. All other embodiments, which can be made by those skilled in the art based on the embodiments of the invention without making any inventive effort, are intended to be within the scope of the invention.
In an embodiment of the invention, an autologous bone piece trimming process comprises the following steps:
Firstly, establishing a model, namely importing preoperative oral cavity CBCT (cone beam CT) data into a medical image control system to reconstruct a jaw model, wherein the medical image control system can be an MIM ICS system;
Designing a prosthesis, namely designing the position and the shape of an ideal prosthesis of the affected part according to the positions and the shapes of the adjacent teeth and the opposite jaw teeth of the affected part, and designing the size and the position of an implant according to the designed position and shape of the ideal prosthesis;
Step three, designing a bone block model, namely designing the size and the shape of a bone block as a bone block model according to the bone mass requirement around the implant and the aesthetic shape of the bone contour around the affected part;
Step four, position adjustment and determination, namely placing the designed bone block model in a bone supply area in a simulation system, adjusting the position of the bone block model, selecting an optimal bone taking site, and avoiding the tooth root and nerve blood tube bundle of surrounding adjacent teeth by at least 2mm;
wherein, the best selected bone taking site is a plurality of, one of which is selected as the final bone taking site;
Fifthly, designing a bone taking guide plate and a trimming guide plate, designing the bone taking guide plate according to the section of a bone block model at the final bone taking position, designing the trimming guide plate according to the designed bone taking guide plate and the simulated bone cutting of the bone block model, and combining the bone block shape required by the bone receiving area;
step six, the designed bone taking guide plate and the trimming guide plate are manufactured by 3D printing, bone blocks in a bone supply area are intercepted and placed into the trimming guide plate, the bone blocks are trimmed according to the form of the trimming guide plate, and the trimmed bone blocks are placed into the final bone receiving part of the bone receiving area;
and seventhly, fixing the bone block trimmed in the step six on a final bone receiving part, making periosteum incision, reducing tension, suturing and closing the wound.
In the embodiment of the invention, the matched prosthesis can be measured and designed according to the actual wound without implementing on a patient by establishing a model, meanwhile, the optimal size and shape of the prosthesis can be accurately obtained, the establishment of a bone block model is guided according to the shape and size of the prosthesis, the safe and optimal bone taking site is selected according to the principle that the minimum trimming is required for the taken bone block, the redundant healthy bones are not damaged, the trimming of the bone block is guided by utilizing the bone taking guide plate and the trimming guide plate, the self-bone is self-implanted, and the stability is greatly improved by fixing the bone block through screws.
In the fourth step, when the optimal bone extraction site is selected, the bone block model is moved to a region where the focus jawbone can safely extract bone, wherein the intraoral bone extraction site comprises a part such as a mandibular ascending branch outer oblique line, a chin part, a maxillary nodule, a palate part and the like;
the optimal bone taking site is selected to be determined according to the shape or the bone quantity of the required bone block.
In the embodiment of the invention, by comparing different placement modes, the minimum adjustment and modification amount of the bone blocks taken out is realized, the bone is taken out within a safe range, and the healthy bones around too much are not damaged.
In the fourth step, when selecting the final bone extraction position, the designed bone blocks to be implanted can be divided into a plurality of parts, the bone blocks required by each part are respectively moved into the jaw bone extraction positions in the simulation system, the positions of the bone blocks of each part are adjusted, and the site requiring the least trimming of the extracted bone blocks is selected as the final bone extraction position.
In the embodiment of the invention, as a plurality of positions of the two-part implant exist, the position with the least trimming amount is selected, so that pain of a patient can be reduced to the greatest extent, and the operation risk is reduced.
In the seventh step, each of the trimmed bone pieces is fixed at the final bone receiving position by 1-2 self-tapping screws.
In the embodiment of the invention, the self-tapping screw is used for fixing the bone block, so that the operation time is reduced to the greatest extent, meanwhile, the pain time of a patient is reduced, the stability of screw fixation is better, and the implanted bone block is ensured to be not loosened in vivo for a long time.
The invention also provides an application of the autologous bone piece trimming process in dental implant, comprising the steps described in the embodiment, wherein the design of the bone taking guide plate is to design four bone cutting planes according to a bone piece model at a final bone taking position, and the bone taking guide plate is designed according to the bone cutting planes;
the design of the trimming guide plate is to simulate osteotomies according to four osteotomies planes in a simulation system, and the trimming guide plate is designed for the osteotomies according to the shape of the osteotomies to be implanted according to the design.
In the embodiment of the invention, because the bone taking guide plate is formed according to the four sections of the bone block model at the final bone taking position, the difference between the taken bone block and the expected shape and size is small, and the uncertain operation risk caused by too much error in the bone taking process is prevented.
As one embodiment of the invention, the middle part of the trimming guide plate can be provided with a plurality of bone cutting grooves, the cut bone blocks are divided into a plurality of parts according to the bone cutting grooves on the trimming guide plate, and the edges of the cut bone blocks are ground according to the edges of the trimming guide plate.
In the embodiment of the invention, the bone blocks cut by the grinding of the trimming guide plate can be matched with the designed bone block model as much as possible, the setting of the implant has reference standard, the guiding significance is great, and the problems of repeated planting and trimming are avoided.
As one embodiment of the invention, the trimmed bone blocks can be divided into a plurality of parts by utilizing a plurality of bone cutting grooves of the trimming guide plate, each part of bone blocks is respectively placed into a bone receiving area at a focus according to the design, and each bone block is respectively fixed at the focus through 1-2 self-tapping screws.
In the embodiment of the invention, the bone block is installed and fixed through the self-tapping screw quickly and stably.
It will be evident to those skilled in the art that the invention is not limited to the details of the foregoing illustrative embodiments, and that the present invention may be embodied in other specific forms without departing from the spirit or essential characteristics thereof. The present embodiments are, therefore, to be considered in all respects as illustrative and not restrictive, the scope of the invention being indicated by the appended claims rather than by the foregoing description, and all changes which come within the meaning and range of equivalency of the claims are therefore intended to be embraced therein.
Furthermore, it should be understood that although the present disclosure describes embodiments, not every embodiment is provided with a separate embodiment, and that this description is provided for clarity only, and that the disclosure is not limited to the embodiments described in detail below, and that the embodiments described in the examples may be combined as appropriate to form other embodiments that will be apparent to those skilled in the art.
Claims (3)
1. An autologous bone piece finishing process, characterized in that the autologous bone piece finishing process comprises the following steps:
Firstly, establishing a model, namely importing preoperative oral cavity CBCT data into a medical image control system, and reconstructing a jaw model;
Designing a prosthesis, namely designing the position and the shape of an ideal prosthesis of the affected part according to the positions and the shapes of the adjacent teeth and the opposite jaw teeth of the affected part, and designing the size and the position of an implant according to the designed position and shape of the ideal prosthesis;
Step three, designing a bone block model, namely designing the size and the shape of a bone block as a bone block model according to the bone mass requirement around the implant and the aesthetic shape of the bone contour around the affected part;
step four, position adjustment and determination, namely placing the designed bone block model in a bone supply area in a simulation system, adjusting the position of the bone block model, selecting an optimal bone taking site, and avoiding the tooth root and nerve blood tube bundle of surrounding adjacent teeth by at least 2mm; wherein, the best selected bone taking site is a plurality of, one of which is selected as the final bone taking site;
Fifthly, designing a bone taking guide plate and a trimming guide plate, designing the bone taking guide plate according to the section of a bone block model at the final bone taking position, designing the trimming guide plate according to the designed bone taking guide plate and the simulated bone cutting of the bone block model, and combining the bone block shape required by the bone receiving area;
Step six, the designed bone taking guide plate and the trimming guide plate are manufactured by 3D printing;
In the fourth step, when the optimal bone taking site is selected, the bone block model is moved to a safe bone taking area of the jawbone; the optimal bone taking site is determined according to the shape or volume of the required bone block, and the commonly used bone taking site comprises a mandibular ascending branch outer oblique line position, a mandibular chin part and a maxillary tuberosity position;
In the fourth step, when the final bone taking position is selected, the designed bone blocks to be implanted can be divided into a plurality of parts, the bone blocks required by each part are respectively moved into the jaw bone taking positions in the simulation system, the positions of the bone blocks of each part are adjusted, and the position needing to carry out the least trimming on the extracted bone blocks is selected as the final bone taking position.
2. Use of an autologous bone piece preparation process in dental implant, comprising an autologous bone piece preparation process as claimed in claim 1, wherein the bone extraction guide is designed to design four osteotomy planes according to a bone piece model at the final bone extraction site, and to design the bone extraction guide according to the osteotomy planes; the design of the trimming guide plate is to simulate osteotomies according to four osteotomies planes in a simulation system, and the trimming guide plate is designed for the osteotomies according to the shape of the osteotomies to be implanted according to the design.
3. The application of an autologous bone piece trimming process according to claim 2, wherein a plurality of bone cutting grooves can be formed in the middle of the trimming guide plate, the cut bone pieces are divided into a plurality of parts according to the bone cutting grooves on the trimming guide plate, and the edges of the cut bone pieces are ground according to the edges of the trimming guide plate.
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| CN110353836A (en) * | 2019-08-06 | 2019-10-22 | 成都优材科技有限公司 | Plantation jawbone and its Digital manufacturing mode with Dental implantion site |
| RU2741363C1 (en) * | 2020-03-23 | 2021-01-25 | Федеральное государственное бюджетное учреждение Национальный медицинский исследовательский центр "Центральный научно-исследовательский институт стоматологии и челюстно-лицевой хирургии" Министерства здравоохранения Российской Федерации | Method of bone autoplasty in atrophy and limited defects of maxillary alveolar process |
| 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 |
| CN112494101A (en) * | 2020-12-16 | 2021-03-16 | 上海交通大学医学院附属第九人民医院 | Multi-block ilium osteotomy and shaping guide plate kit for mandible defect repair |
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