上颌骨复杂缺损3D打印精准重建支架的生物力学研究
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1.北京航空航天大学 生物医学工程高精尖创新中心;2.重庆医科大学附属口腔医院

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Biomechanical study of 3D printing accurate reconstruction scaffold for complex maxillary defects
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    摘要:

    目的 本研究提出一种用于修复上颌骨大面积骨缺损的3D打印植入体设计、优化、制造的个性化方案。方法 基于患者CBCT和口腔扫描数据信息,首先进行植入体优化设计;其次采用有限元分析方法对植入体的结构迭代优化与材料选择。模拟植入体在口腔内的受力情况,得到植入体所受应力的大小、传导方向与分布,据此对植入体结构进行优化。最后比较同种构型植入体在钛合金、钽金属、Peek三种不同材料下的最大等效应力、颌骨最大等效应力和钛钉的总位移,确定植入体的打印材料。采用3D打印技术打印植入体,临床进行面部重塑和咬合重建。结果 经过结构迭代优化得出植入体的最佳构型,对比同种构型下三种不同材料的最大等效应力、颌骨最大等效应力和钛钉的总位移,确定选择钛合金材料。3D打印植入体应用于临床,完成了咬合重建。 结论 本研究描述的个性化方案具备临床可行性,适用于不同分类的上颌骨缺损病例。设计出的植入体尺寸精确、力学性能良好,不仅恢复患者的颌面部外形,还满足了临床对颌骨缺损修复后咬合重建的需求,证明了该方案的有效性和实用性。

    Abstract:

    Objective In this study, a personalized design, optimization and manufacturing method of 3D printing implant for repairing large area of maxillary defect was proposed. Method Based on the patient's CBCT and oral scan data information to design the implant; Using finite element analysis method to iteratively optimize the structure and material selection of the implant. Simulate the force of the implant in the oral cavity, obtain the magnitude, conduction direction and distribution of the stress on the implant, and optimize the structure of the implant accordingly. Finally, compare the maximum equivalent stress, the maximum equivalent stress of the jaw bone and the total displacement of the titanium screws under the three different materials of titanium alloy, tantalum metal, and Peek of the same configuration, and determine the printing material of the implant. Use 3D printing technology to print the implant, and the clinical surgery to facial remodeling and occlusal reconstruction. Result Through the iterative optimization of the structure, the best configuration of the implant is obtained. Compare the maximum equivalent stress, the maximum equivalent stress of the jaw bone and the total displacement of the titanium screws of three different materials under the same configuration, the titanium alloy material was selected. 3D printed implants were used in the clinic to complete the occlusal reconstruction. Conclusion The method described in this study has clinical feasibility and is suitable for different types of maxillary defect cases. It not only restores the patient's maxillofacial appearance, but also meets the clinical needs of occlusal reconstruction after maxillofacial defect repair, which proves the effectiveness and practicability of this method.

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  • 收稿日期:2021-07-22
  • 最后修改日期:2021-10-04
  • 录用日期:2021-10-11
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