CAD And 3D Technology With Vascularized Fibula In Mandibular Defects Reconstruction

Objective This study uses computer-aided design and 3D technology to repair mandibular defect with vascularized fibula free transplantation.The preoperative design and surgical guide plate are used to improve the accuracy of reconstruction of the mandible and improve the efficiency of the operation.To explore the clinical application of computer-aided design and 3D printing technique combined with vascularized fibula free graft in the repair of mandible defect,and to discuss the accuracy and efficiency of reconstruction of mandible.Methods A total of 22 patients(including 12 male patients and 10 female patients)were selected from the oral and maxillofacial surgery of the Affiliated Stomatological Hospital of Guangxi Medical University(including 12 male patients,10 female patients),the minimum age of 22 years,the maximum age of 52 years,and the average age of 36.6 years(all approved by the Guangxi Medical University ethics committee).Exclusion criteria: preoperative unilateral mandibular defect and displaced pathological fracture.All of the above patients were examined and scanned by the maxillofacial spiral CT before the operation,and 11 patients(experimental group)were applied to the computer software,the computer software was used to reconstruct the mandible defect and to design the fibula shape guide plate in the bone defect area,and then the complete data was designed.Store it.Then the solid model of the mandible was produced by the rapid prototyping technology.The osteotomy range was planned and the titanium plate was prebent before the operation.The mandibular defect was repaired by the preoperative scheme combined with vascularized fibula free transplantation.The other 11 patients(control group)did not perform digital simulation and production before operation,but only the method of vascularized fibula free transplantation was used to repair the mandible defect.One week after the operation(7D),each patient was scanned with spiral CT on the maxillofacial region.The preoperative and postoperative data of each patient were introduced into the computer software,and the three-dimensional image of the head before and after the operation was registered with the Mimics17.0 software(the above jaw was the standard).The preoperative and postoperative markers were set to measure all the postoperatively.The distance between the mark point(bilateral condyle,bilateral mandibular angle,mental point)and the distance between the experimental group and the control group before and after operation were compared by independent sample T test.At the same time,the operation time of the experimental group and the control group was recorded,and the accuracy and efficiency of the computer-aided design combined with the 3D printing technique combined with vascularized fibula free transplantation for the reconstruction of the mandible defect were discussed.Results The use of computer-aided design and 3D printing technique combined with vascularized fibula free transplantation to repair mandibular defect can be performed before the operation,the design of the operation scheme and the design of the guide plate.The rapid reconstruction can be carried out according to the guide plate during the operation,and the ideal effect has been obtained.The distance between the experimental group and the control group and the operation time were analyzed by independent sample T test.The results show that the average moving distance of each site of mandible repair and reconstruction using computer aided design and 3D printing technique is less than that of using conventional methods to repair the moving distance of each site of mandible defect.There was a significant difference between the experimental group and the control group in the distance of the chin chin vertex movement(3.74 + 1.57 mm,7.82 + 4.33 mm,P=0.012),and there was no significant difference between the other markers.However,there was a significant difference in overall movement distance(5.20 + 1.91 mm,7.11 + 2.69 mm,P=0.000).The average operative time in the experimental group was less than that in the control group,and there was a significant difference(8.28±1.17 h ?? 9.45±0.94 h,P=0.018).Conclusion The use of computer-aided design and 3D technique combined with vascularized fibula free transplantation to repair the mandible defect can improve the speed and accuracy of the reconstruction of the mandible,and it is an effective and rapid repair method.