Study Of Clinical Values Of Computer Aided Surgery System And 3D Printing In The Reconstruction Of The Defects Of Mandible

Objective:Computer aided surgery system(CAS)greatly improved the operation accuracy combined with 3D printing technology based on three dimensional images from CT scan data,through building a reconstruction digital model,generating a personalized surgical model,pre-surgical simulation and titanium plate molding,guiding surgical procedure,et al.It was to evaluate the clinical values of CAS and 3D printing in the reconstruction of the defects of mandible and explore the advantages and clinical application.Methods:Twenty cases with mandible resection and reconstruction in Department of Oral and Maxillofacial Surgery,the Affiliated Hospital of Qingdao University were enrolled from May 2015 to January 2016.All cases were given free fibular flap to reconstruct the mandible defects.They were randomly divided into two groups: traditional surgery group and computer assisted group,each group with 10 patients.The traditional surgery group was further divided in to two sub groups,Traditional group I(5 patients)and Traditional group II(5 patients).Traditional group I: destruction of mandible surface,impossible to mold a titanium plate preoperatively,titanium plate molding based on the experience of surgeon.Traditional group II: the bone surface completely,preoperative titanium plate molding on the surface of mandible.The patients in the computer assisted group were underwent spiral CT scan.The data were input Mimics10.0 software to produce a three-dimensional reconstruction digital model,one original model and one mirror model by mirror image and reverse technology.Then the digital models were printed into a real model through 3D printing.Preoperative titanium plate molding was made on the model.Blood loss and operating time were recorded and analyzed.Facial contour and biting function were evaluated.Patient satisfaction were investigated.Results:There was no statistical significance(P>0.05)in operating time and blood loss between traditional surgery group I and traditional surgery group II.However,the operation time and blood loss of traditional surgery group were significantly higher than those of the computer assisted surgery group(P<0.01).Facial contour and biting function were well in all cases of groups,no statistical significance(P>0.05).Patient satisfaction in appearance,chewing and pronunciation were no statistical significance(P>0.05)between traditional surgery group and the computer assisted surgery group.Conclusions:1Computer assisted system with 3D printing could precisely complete preoperative titanium plate molding to reduce operation time and blood loss in he reconstruction of the defects of mandible.2 Computer assisted system with 3D printing could obtain great facial contour and biting function in he reconstruction of the defects of mandible.3 Computer assisted system with 3D printing could achieve high level of patient satisfaction in appearance,chewing and pronunciation.It was valuable in the clinical application.