- 期刊
Application of 3-Dimensional Casting Model from CT Scan in the Orthognathic Surgery to Correct Facial Asymmetry-A Case Report
利用3-D模型應用在臉型不對稱患者之正顎手術病例報告
摘要
在治療臉型不對稱(facial asymmetry)之患者時，單純的矯正治療並無法解決臉型不對稱問題，往往需合併正顎手術之進行。傳統上利用牙齒模型搭配2-D的影像(pano x-ray, cepha: lateral and PA view x-ray)來設計手術治療計畫，但這種方式對於此類facial asymmetry患者的治療上有其盲點，尤其是在axial plane上的設計常會因傳統2-D影像paper surgery無法在咬合器上模擬而真正得知移動所需的量。為改正此缺點，因此我們利用3-D頭顱模型來設計新的手術方式。本次案例報告為18歲（手術時年紀）女性，經臨床診斷為Class Ⅲ malocclusion with facial asymmetry，治療計畫為合併上下顎正顎手術之矯正治療。利用3-D頭顱模型模擬手術之進行，並設計guiding plate及surgical stent以提供醫師開刀時之依據，此患者術後良好並得到不錯之臉型對稱性，此搭配3D模型輔助定位的新手術方式的確能後得更精準的術後結果。
並列摘要
In treating patients with facial asymmetry, orthognathic surgery is often needed in combination with orthodontic treatment. Conventional surgical treatment planning uses dental casts and two-dimensional radiography to predict the amount of movement needed. However, the real movement modeled on the mounted casts on the articulator cannot be simulated accurately based on the two-dimensional radiographs. In this case report, we presented a new method using three-dimensional casting model for surgical planning and design.This case report presented an 18-year-old female (at the time of surgery), diagnosed as Class Ⅲ malocclusion with facial asymmetry. The surgical plan was orthodontic treatment combined with two-jaw orthognathic surgery. We used a three-dimensional casting model to design the guiding plate and surgical stent and simulated the real surgery. The guiding plate and surgical stent provided the surgeon a guide during surgical procedure. The patient's facial profile was greatly improved after surgery, and the result was satisfying. This new method of designing treatment helped the surgeon in achieving a more precise surgical result.