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• W3102907402 abstract "To investigate the influence of the design and application of novel surgical template on the accuracy of reconstructed mandibula and implant position in occlusion-guided functional mandibular reconstruction, so as to provide guidance for clinical treatment.Between January 2017 and May 2019, 11 patients with segmental mandible defects were treated, including 8 males and 3 females with an average age of 31.8 years (range, 19-45 years). There were 6 cases of ameloblastoma, 3 cases of keratocystic tumor, and 2 cases of ossifying fibroma. According to Urken classification of mandible defects, there were 1 case of CRB, 4 cases of RB, 2 cases of RBS, and 4 cases of SB. According to the occlusion relationship, a novel surgical template with the reconstruction titanium plate screws and implants drill-guided information was designed and manufactured. With the help of the novel surgical template, the one and a half fibula reconstruction mode was used for jaw functional reconstruction, and the implant supported denture was finally completed. The postoperative CT at 1 week were collected to analyze the morphology of the preoperative virtual design jaw and postoperative jaw. The coincidence of fibular reconstructed mandible (fibular upper barrel, fibular reconstructed ramus and condyle, and whole mandible) and implant in mandible were calculated. When the coincidence was less than 80%, it was considered that the deviation was obvious. Oral panoramic X-ray film and cone beam CT were examined at 6 months after operation to evaluate the osseointegration before implant repair.None of the 11 flaps had postoperative vascular crisis. One flap occurred necrosis at 1 month after reconstruction combined with 3 implants failed, and had been removed at 6 months after reconstructed surgery; the others had no flap necrosis. One week postoperatively, the coincidence of the fibular upper barrel was 87.55%±3.08%, the whole mandible was 82.68%±5.94%, and the implant in mandible was 88.00%, with significant differences ( t=8.131, P=0.000; t=2.118, P=0.046; Z=4.070, P=0.000) when compared to 80%, respectively. The fibular reconstructed ramus and condyle was 77.82%±3.54%, with no significant difference ( t=-2.042, P=0.068) when compared to 80%. Six months postoperatively, oral panoramic X-ray film and cone beam CT showed that all 22 implants achieved osseointegration and the palatal mucosa transplantation was performed, then finally completed the denture rehabilitation at 6-9 months after operation. All patients were satisfied with their postoperative appearance.The novel surgical template can guarantee the accuracy of functional mandible reconstruction guided by occlusal guidance, and ultimately achieve the beautiful contour of jaw and occlusal function reconstruction, and improve the patient's life quality.探讨在咬合引导下功能性颌骨重建中，新型外科导板的设计应用对新建颌骨以及种植体位置的精度影响，为临床治疗提供指导。.2017 年 1 月—2019 年 5 月收治 11 例下颌骨节段性缺损患者，其中男 8 例，女 3 例；年龄 19～45 岁，平均 31.8 岁。下颌骨肿瘤病理诊断为成釉细胞瘤 6 例、角化囊性瘤 3 例、骨化纤维瘤 2 例。下颌骨缺损根据 Urken 下颌骨缺损分类法分类，CRB 1 例，RB 4 例，RBS 2 例，SB 4 例。以咬合为引导，设计并制备具有钛板钉道和种植体位置信息的新型外科导板，在其辅助下采用“一层半”腓骨重建模式进行颌骨功能性重建，并最终完成种植体支持式义齿修复。采集术后 1 周 CT 数据，对术前虚拟设计颌骨和术后颌骨进行形态学分析，计算腓骨段（上层水平部、升支部及整个腓骨段）和种植体的拟合度，当拟合度<80% 认为是偏差明显。术后 6 个月检查口腔全景 X 线片和锥束 CT，评价种植体修复前的骨结合情况。.术后 11 例皮瓣均未发生血管危象。1 例皮瓣于术后 1 个月皮瘘形成，术后 6 个月手术取出腓骨瓣及 3 枚种植体；余 10 例患者皮瓣成活。术后 1 周，对术前虚拟设计颌骨和术后颌骨进行形态学分析显示，上层水平部腓骨段、整个腓骨段及种植体拟合度分别为 87.55%±3.08%、82.68%±5.94% 和 88.00%，与 80% 比较差异均有统计学意义（ t=8.131， P=0.000； t=2.118， P=0.046； Z=4.070， P=0.000）；升支部腓骨段拟合度为 77.82%±3.54%，与 80% 比较差异无统计学意义（ t=−2.042， P=0.068）。术后 6 个月口腔全景 X 线片和锥束 CT 示 22 枚种植体均实现了骨结合，并于术后 6～9 个月进行腭黏膜移植以及种植体支持式固定义齿的修复。所有患者对于术后外形均较满意。.新型外科导板可为咬合引导下功能性颌骨重建提供精度保证，最终恢复颌骨轮廓和咬合功能重建，提高患者生活质量。." @default.
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• W3102907402 date "2020-11-15" @default.
• W3102907402 modified "2023-10-16" @default.
• W3102907402 title "[Clinical application and accuracy analysis of occlusion-guided functional mandibular reconstruction]." @default.
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• W3102907402 doi "https://doi.org/10.7507/1002-1892.202004081" @default.
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