- 期刊
使用3D列印製作物理性假體模擬下顎第三大臼齒自體牙移植手術：病例報告
Use of 3D Printing Physical Phantom to Simulate the Lower Right Third Molar in Autotransplantation: A Case Report
摘要
自體牙移植手術的成功在於移植後新生成的牙周韌帶是否能恢復功能，減少口外臨床操作時間可以提高治療成功率。我們使用錐狀射束電腦斷層掃描（cone beam computed tomography，CBCT）並透過3D列印複製手術區域的模型，稱為物理性假體（physical phantom），進行診斷、3D型態分析、術前治療計畫和手術模擬。本病例報告為21歲女性，右下第二大臼齒因牙冠牙根齲齒而必須拔除，初步治療計畫為使用第三大臼齒進行自體牙移植，取代右下第二大臼齒。預先安排病人照射電腦斷層攝影，並透過物理性假體進行術前治療計畫和手術模擬，依據手術計畫進行自體牙移植手術。錐狀射束電腦斷層和物理性假體對於了解移植牙齒和周圍解剖構造。本病例報告顯示透過製作的物理假體模擬術前自體牙移植手術，可以有效減少手術傷害及縮短移植牙在口外暴露時間，提高移植手術成功率。
並列摘要
The maintenance of healthy periodontal ligament cells in the donor tooth is one of the most important factors for successful tooth transplantation. This is achieved by minimizing the extraoral time of the donor tooth during the surgical procedure. We describe a case of autotransplantation of a mandibular right horizontally impacted third molar using a physical phantom, a duplicated model based on cone-beam computed tomography (CBCT) images, for diagnosis, 3D morphological evaluation, preoperative treatment planning, and surgical simulation. In the present case, a 21-year-old female patient underwent autotransplantation of lower right third molar to replace unrestorable adjacent right second molar due to crown and root caries. Physical phantom of mandibular right second, third molars and recipient site for preoperative diagnosis were fabricated and surgical simulation of autotransplantation was performed. The autotransplantation was then performed accordingly. CBCT images and physical phantom were extremely useful in obtaining a stereoscopic understanding of the morphology of the transplanted tooth and its surrounding anatomical structures. Our experience of using physical phantom fabricated based on CBCT images for preoperative diagnosis and surgical simulation suggests that this technique is useful in tooth autotransplantation to decreases the risk of iatrogenic damage and the extra-alveolar time of the transplanted tooth is minimized. This facilitates a successful outcome.
延伸閱讀
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