供牙三维打印模型在自体牙移植围手术期应用的临床观察

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目的:观察并总结供牙三维打印模型在自体牙移植围手术期的应用情况,以期为临床提供参考。方法:研究分为两部分:回顾性收集192例自体牙移植术病例(2017年9月至2019年8月于第四军医大学口腔医学院口腔颌面外科就诊,单颗牙移植),男性107例,女性85例,年龄(34.2±10.7)岁;通过临床和影像学检查初次预判供牙能否完整拔除,辅以供牙三维打印模型进行二次预判,并计算与实际结果的一致率。前瞻性收集64例拟行自体牙移植术的病例(2017年9月至2019年8月于第四军医大学口腔医院口腔颌面外科就诊,单颗牙移植),男性28例,女性36例,年龄(30.2±8.3)岁,根据随机数表法随机分为模型组和供牙组(每组32例),对模型组患者使用供牙三维打印模型于术中辅助预备牙槽窝并于术后辅助根管治疗,供牙组不使用三维打印模型;比较两组上颌或下颌牙槽窝预备时间、供牙离体时间、供牙试植次数以及术后开髓和根管定位时间。结果:二次预判与实际结果的一致率[97.4%(187/192)]显著高于初次预判与实际结果的一致率[93.2%(179/192)](n P<0.05)。模型组上颌和下颌受牙区牙槽窝预备时间分别为(18.8±4.6)和(22.7±3.4) min,供牙离体时间分别为(3.0±0.6)和(2.1±0.6) min,供牙试植次数分别为(1.3±0.8)和(1.0±0.9)次,术后开髓和根管定位时间分别为(4.3±0.6)和(4.0±0.5) min,均分别显著小于供牙组上颌和下颌(n P<0.05)。n 结论:三维打印供牙模型制作准确,在自体牙移植术中应用可缩短受牙区牙槽窝预备时间、供牙离体时间及减少供牙试植次数,并可辅助提高术前对供牙能否完整拔除的预判准确性以及术后缩短供牙开髓和根管定位时间。“,”Objective:To prepare a three-dimensional (3D) printing donor tooth model and to observe its application in the peri-operative period.Methods:In part one, 192 cases (2017.9-2019.8) from Department of Oral & Maxillofacial Surgery, School of Stomatology, The Fourth Military Medical University [107 males and 85 females, age (34.2±10.7) years] which need autotransplantation of teeth (ATT) were collected. Whether the donor teeth can be completely extracted was predicted through clinical and imaging examination (first prediction). The second prediction was supplemented by the three-dimensional printing model of the donor teeth. Each of the prediction was compared with the actual results and the coincidence rate was calculated. In part two, 64 cases (2017.9-2019.8) from Department of Oral & Maxillofacial Surgery, School of Stomatology, The Fourth Military Medical University [28 males, 36 females, age (30.2±8.3) years] which need ATT were randomly divided into the model group and the donor group. The time of alveolar fossa preparation, time of donor tooth n in vitro, times of trial implantation and time of pulptomy and root canal location were recorded respectively.n Results:In part one, the coincidence rate between the second prediction and the actual results [97.4%(187/192)] was significantly higher than that of the first prediction [93.2%(179/192)] (n P<0.05). In part two, the preparation time of the alveolar fossa in the maxillary and mandibular were (18.8±4.6) and (22.7±3.4) min, the time of the teethn in vitro were (3.0±0.6) and (2.1±0.6) min, the times of trial implantation were (1.3±0.8) and (1.0±0.9), and the time of pulpotomy and root canal location were (4.3±0.6) and (4.0±0.5) min. All values in the model groups were better than those in the donor group (n P<0.05).n Conclusions:The 3D printing model is accurate. It can be used in autogenous tooth transplantation to shorten the preparation time of alveolar fossa and time of donor tooth n in vitro, and reduce the times of trial implantation of donor teeth, and to help to improve the prediction accuracy of complete extraction of donor teeth and the time of pulpotomy and root canal location.n
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