CN103202729B - A kind of individuation upper jaw bone osteotomy and relocate the manufacture method of guide entity - Google Patents
A kind of individuation upper jaw bone osteotomy and relocate the manufacture method of guide entity Download PDFInfo
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- CN103202729B CN103202729B CN201210012975.7A CN201210012975A CN103202729B CN 103202729 B CN103202729 B CN 103202729B CN 201210012975 A CN201210012975 A CN 201210012975A CN 103202729 B CN103202729 B CN 103202729B
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Abstract
The present invention relates to a kind of individuation upper jaw bone osteotomy and relocate the manufacture method of guide entity, it comprises the steps: one, upper jaw bone concrete form according to patient's head three-dimensional digitalization model provides osteotomy site, osteotomy region and postoperative preferable upper jaw bone locus, the outer surface of preferable upper jaw bone；Two, upper jaw bone osteotomy guide entity is designed according to virtual osteotomy position and osteotomy region, three, that designs the upper jaw bone bone piece that need to move relocates guide entity, and four, use rapid prototyping technology to make overall navigation entity.Advantage of the present invention is as follows: the present invention is according to osteotomy guide entity and the Digital Three-Dimensional geometric model relocating guide entity, rapid prototyping technology is used to make overall navigation entity, guide bone saw by the osteotomy site formulated in preoperative digitization program and the accurate osteotomy of osteotomy amount, move to the upper jaw bone bone piece of postoperative ideal space position by mating maintenance with the laminating relocating guide entity, it is achieved the digitized of operation, simplification, precision and controlledization.
Description
Technical field
The present invention relates to the navigation in a kind of medical image, particularly relate to a kind of individuation upper jaw bone osteotomy and again
The manufacture method of location navigation entity.
Background technology
Along with the development of social economy and culture, people are attractive in appearance deeply concerned all the more to self looks, it is desirable to pass through shaping
Operation improves the patient of maxillofacial bone sex deviation and increases the most day by day.The topmost treatment side of cranium Maxillary region bone sex deviation
Formula is surgical operation therapy, by reorientating upper and lower jawbone bone piece, makes that patient's looks are attractive in appearance to be changed
Kind.Owing to aesthetic is increased by people day by day, the accuracy requirement of plastic operation is increased the most day by day.
In traditional treatment mode, patient needs by the way of facebow shifts, by the plaster mold of upper mandibular dentition
Type is transferred and resettled on half adjustable jaw frame.By design and the making of model surgery, respectively in mobile representative
The plaster model of mandibular bone bone piece determines that jawbone bone piece needs the locus moved to, and makes mouth guard
Use in art.This process needs to expend substantial amounts of manpower and time, and there is many potentialities
Error.When these errors all can cause performing the operation, jawbone bone piece can not reach the most optimal locus, from
And affect the improvement that patient's looks are attractive in appearance.Operation is controlled by mouth guard the position of jawbone bone piece, has steady
The shortcomings such as qualitative difference and complex operation.Conventional surgical treatment in, the position of osteotomy and need remove bone piece many
In art, rule of thumb determined there is poor accuracy and be difficult to the shortcomings such as grasp less completely by operative doctor.
Along with the development of computer technology, Computer assisted surgery has had more and more extensive at surgical field
Application.Doctor can be according to the three-dimensional digital model of patient CT data's reconstruction patients head, in a computer
Carry out virtual operation by Computer assisted surgery, bone piece is blocked and moves.By to difference
The simulation of operation plan and comparing, finally determines optimal surgical planning.But these digitized operation meters
Draw and be difficult to be converted to the concrete operations of actual guided operation doctor in art exactly.At present conventional by preoperative number
It is surgical navigation technology that word surgical planning is converted to method actual in art.Surgical navigation system structure complexity,
Art need the equipment used more, including display, computer, navigation position instrument and tracer etc.；Behaviour
Make process numerous and diverse, often need to repeatedly registrate and position.And the surgical navigation technology space bit to a single point at present
Put and determine more maturation, the structure of form so complicated for cranium jawbone bone piece, still can not carry out good sky
Between position.In the problem that surgical navigation technology self is deposited simultaneously, real-time error during as registrated in art and art
The problems such as tissue displacement all remain to be further improved.Factors above all limits extensively pushing away of surgical navigation technology
Wide and application.
Summary of the invention
It is an object of the invention to provide a kind of individuation upper jaw bone osteotomy and again for prior art weak point
The manufacture method of location navigation entity.The method is for this common cranium Maxillary region of deformitas maxillaris surgical plastic
Operation, manufactures personalized surgical navigational entity by computer-aided design and rapid prototyping technology, specifically
Guided operation doctor's art operates, it is achieved upper jaw bone three-dimensional accurately osteotomy and bone piece three-dimensional accurately relocate, and make
Preoperative digitized operation plan can accurately be converted in art operation reality.
The present invention is by the following technical programs in realize: a kind of individuation upper jaw bone osteotomy and relocate navigation
The manufacture method of entity, it is characterised in that it comprises the steps:
Step one, in the preoperative patient's head is carried out CT scan, rebuild according to CT scan data before operation in patients
Patient's head three-dimensional digitalization model；Determine that in the operation of upper jaw bone bone piece Virtual cropping, upper jaw bone bone piece is three
Dimension needs excision and the direction of movement and distance on direction；Then be given according to patient's upper jaw bone concrete form and cut
The position of bone is put, osteotomy region and postoperative preferable upper jaw bone locus, the outer surface of preferable upper jaw bone；
Step 2, then according to virtual osteotomy position and osteotomy region, use cad technique to design upper jaw bone
Osteotomy guide entity, described osteotomy guide entity is made up of two, left and right parts, two component forms structure bases
This symmetry, is individually fixed in the former maxilla surface in left and right, the inner surface of osteotomy guide entity and former upper jaw bone table
Face fits tightly, and the outer surface form of osteotomy guide entity is determined by former maxilla surface form, and osteotomy is navigated
The outer surface of entity sets position hitching post, and osteotomy guide entity is fitted with maxilla surface and reaches the most stable
Fixing after position, osteotomy guide entity osteotomy district is provided with osteotomy labelling, excises osteotomy region by osteotomy labelling,
In digitized operation plan, three-dimensional osteotomy site and osteotomy region are stored in osteotomy navigation in the way of morphosis
In entity；
Step 3, then according to upper jaw bone remainder and be positioned at postoperative preferable upper jaw bone space bit after cutting
The upper jaw bone bone piece put uses what cad technique designed the upper jaw bone bone piece that need to move to relocate guide entity,
Described relocate guide entity inner surface and osteotomy guide entity outer surface, to be positioned at postoperative preferable upper jaw bone empty
Between the upper jaw bone bone piece surface of position fit tightly, relocate guide entity outer surface form by the preferable upper jaw
The outer surface of bone determines, relocates guide entity top and is provided with that to position hitching post with osteotomy guide entity two corresponding
Two keyholes, relocate guide entity and osteotomy guide entity by two keyholes and form firm hitching post and lock
Knot, relocate guide entity be positioned at postoperative preferable upper jaw bone locus upper jaw bone bone piece laminating and reach
Fix after the most stable position, by making digitized operation side with upper jaw bone bone piece laminating form Design
In case, bone piece three-dimensional space position is stored in the way of morphosis and relocates in guide entity；
Step 4, finally according to osteotomy guide entity and the Digital Three-Dimensional geometric model that relocates guide entity,
Rapid prototyping technology is used to make overall navigation entity；In art, osteotomy guide entity is stably fitted and is seated on former
Jawbone surface of bone, guides bone saw to press the osteotomy site and the accurate osteotomy of osteotomy amount formulated in preoperative digitization program,
Move to the upper jaw bone bone piece of postoperative ideal space position by mating maintenance with the laminating relocating guide entity,
Bone piece three-dimensional space position determined by the digitized operation plan relocated in guide entity will be stored in art
In accurately present, upper jaw bone bone piece achieves in art and is accurately positioned, preoperative digitized operation meter
The scheme of drawing accurately is converted to operation reality.
The present invention takes following measure further:
Osteotomy region described in step one refers to: after the upper jaw sections, if needing to move up, it is necessary to
Remove a part and bone piece can be moved the bone producing stop, so that upper jaw bone bone piece can move to smoothly
Required position.
In step 2, osteotomy guide entity non-osteotomy area top is the most unique with the laminating of upper jaw bone remainder surface
It is fixed as after stable position on osteotomy guide entity, be drilled into few 2 holes, runs through guide entity, penetrate
Surface of bone, fixes osteotomy guide entity with jawbone surface of bone with screw.
Osteotomy described in step 2 is labeled as accommodating the groove structure of electric saw blade, groove structure and osteotomy line position
Put and coincide consistent with osteotomy amount.
After relocating guide entity in step 3 and moving, upper jaw bone bone piece is fitted and after the most stable position
It is fixed as being drilled into few 2 holes on guide entity relocating, runs through guide entity and osteotomy guide entity and wear
Enter surface of bone, then use fastened by screw.
The positive effect of the present invention is: the present invention propose a kind of individuation upper jaw bone osteotomy and relocate navigation
The manufacture method of entity, has the advantage that 1) present invention is according to osteotomy guide entity and relocates navigation in fact
The Digital Three-Dimensional geometric model of body, uses rapid prototyping technology to make overall navigation entity, guides bone saw to press
The osteotomy site formulated in preoperative digitization program and the accurate osteotomy of osteotomy amount, move to postoperative ideal space position
Upper jaw bone bone piece by mating maintenance with the laminating relocating guide entity, it is achieved upper jaw bone three dimensions essence
Really osteotomy and relocating, it is achieved the digitized of operation, simplification, precision and controlledization, substantially reduces
Operating time, alleviates the misery of patient, achieves significant technological progress and good society and economic effect
Benefit；2) relative to traditional treatment process, this guide entity is made by Computer Design completely, and degree of accuracy is high,
Error is little, decreases substantial amounts of manual labor；3) relative to existing airmanship, this guide entity art makes
With simply, it is not necessary to other redundant equipments, it is possible to accurately guided operation doctor operation；4) this guide entity is permissible
Accurately preoperative digitized operation plan is converted in art reality, substantially increases operation precision, it is achieved warp
Testing surgical procedures is to digitized transformation.
Detailed description of the invention
Below in conjunction with embodiment, the invention will be further described:
A kind of individuation upper jaw bone osteotomy and relocate the manufacture method of guide entity, it comprises the steps:
Step one, in the preoperative patient's head is carried out CT scan, rebuild according to CT scan data before operation in patients
Patient's head three-dimensional digitalization model；Determine the operation of upper jaw bone bone piece Virtual cropping needs on three-dimensional
The direction of movement and distance；Then according to patient's upper jaw bone concrete form be given osteotomy site, osteotomy region,
And postoperative preferable upper jaw bone locus, the outer surface of preferable upper jaw bone；Described osteotomy region refers to:
After the upper jaw sections, if needing to move up, it is necessary to remove a part and bone piece can be moved generation resistance
The bone of gear, so that upper jaw bone bone piece can move to required position smoothly.Accurately determine osteotomy region
Practical significance be, disposable remove unwanted bone piece, be avoided that the removal repeatedly to bone piece and removing,
Reduce operating time and intraoperative hemorrhage；It also avoid simultaneously too much bone and cause artificial, unnecessary
Gap, reduces the unnecessary wound to patient.Therefore the determination in osteotomy region relate to the face after operation in patients,
Postoperative effect and the success of operation.
Step 2, then according to virtual osteotomy position and osteotomy region, use cad technique to design upper jaw bone
Osteotomy guide entity, described osteotomy guide entity is made up of two, left and right parts, two component forms structure bases
This symmetry, is individually fixed in the former maxilla surface in left and right, the inner surface of osteotomy guide entity and former upper jaw bone table
Face fits tightly, and the outer surface form of osteotomy guide entity is determined by former maxilla surface form, and osteotomy is navigated
The outer surface of entity sets position hitching post, and osteotomy guide entity and maxilla surface are fitted in the most stable position
Fixing afterwards, osteotomy guide entity osteotomy district is provided with osteotomy labelling, excises osteotomy region, number by osteotomy labelling
In word operation plan, three-dimensional osteotomy site and osteotomy region are stored in osteotomy navigation in fact in the way of morphosis
In body.The purpose of osteotomy guide entity set in this step is to carry out osteotomy more accurately.First, cut
Bone guide entity and maxilla surface are fixing after being fitted in the most stable position, may during to avoid osteotomy
The displacement occurred.The most stable described position be osteotomy guide entity inner surface with former maxilla surface
Fit like a glove.Described being fixed as is drilled into few 2 holes on osteotomy guide entity, runs through guide entity, penetrates
Surface of bone, is fixed up osteotomy guide entity with jawbone surface of bone with screw.Excise according to osteotomy labelling during osteotomy
Osteotomy region, described osteotomy is labeled as accommodating the groove structure of electric saw blade, groove structure and osteotomy line position
Coincideing consistent with osteotomy amount, the groove structure in osteotomy region guides electric saw accurately to cut, thus improves operation
Accuracy.The location relocating guide entity that location hitching post is next step on osteotomy guide entity surface
Be given with reference to foundation.
Step 3, then according to upper jaw bone remainder and be positioned at postoperative preferable upper jaw bone space bit after cutting
The upper jaw bone bone piece put uses what cad technique designed the upper jaw bone bone piece that need to move to relocate guide entity,
Described relocate guide entity inner surface and osteotomy guide entity outer surface, to be positioned at postoperative preferable upper jaw bone empty
Between the upper jaw bone bone piece surface of position fit tightly, relocate guide entity outer surface form by the preferable upper jaw
The outer surface of bone determines, relocates guide entity top and is provided with that to position hitching post with osteotomy guide entity two corresponding
Two keyholes, relocate guide entity and osteotomy guide entity by two keyholes and form firm hitching post and lock
Knot, relocate guide entity be positioned at postoperative preferable upper jaw bone locus upper jaw bone bone piece laminating and reach
Fix after the most stable position, by making digitized operation side with upper jaw bone bone piece laminating form Design
In case, bone piece three-dimensional space position is stored in the way of morphosis and relocates in guide entity.In this step
The guide entity that relocates designed according to cad technique first passes through two keyholes thereon with osteotomy navigation in fact
Body forms firm hitching post lock knot, after establishing the location relocating guide entity, then with move to postoperative ideal
Locus upper jaw bone bone piece laminating, after obtaining the most stable position by upper jaw bone bone piece with relocate
Navigation body is fixed, and the most stable described position is the inner surface relocating guide entity and move to postoperative ideal
The upper jaw bone bone piece outer surface of locus fits like a glove.Described being fixed as is drilled on guide entity relocating
Few 2 holes, run through guide entity and osteotomy guide entity and penetrate surface of bone, then using fastened by screw.By this
The movement of upper jaw bone bone piece has been stored in the morphosis relocating guide entity by the method for sample.
Step 4, finally according to osteotomy guide entity and the Digital Three-Dimensional geometric model that relocates guide entity,
Rapid prototyping technology is used to make overall navigation entity；In art, osteotomy guide entity is stably fitted and is seated on former
Jawbone surface of bone, guides bone saw to press the osteotomy site and the accurate osteotomy of osteotomy amount formulated in preoperative digitization program,
The upper jaw bone bone piece moving to postoperative ideal bit mates maintenance by relocating the laminating of guide entity, will be stored in
Relocate bone piece three-dimensional space position determined by the digitized operation plan in guide entity in art accurately
Presenting, upper jaw bone bone piece achieves in art and is accurately positioned, and preoperative digitized surgical planning scheme is accurate
Really be converted to operation reality.In operation, bone saw can be guided to cut by preoperative formulation according to osteotomy guide entity
The accurate osteotomy of bone line, the upper jaw bone bone piece cut down is accurately positioned by relocating guide entity, preoperative numeral
Change surgical planning scheme and be accurately converted to operation reality.
Describe structure and the manufacture method of guide entity of the present invention above in conjunction with embodiment, be not intended that this
The restriction of invention, in this area, those skilled in the art can show that needs are made adjustment, in appended right according to real
Various deformation or amendment is made all in protection domain in the range of requirement.
Claims (5)
1. an individuation upper jaw bone osteotomy and relocate the manufacture method of guide entity, it is characterised in that it
Comprise the steps:
Step one, in the preoperative patient's head is carried out CT scan, according to CT scan data weight before operation in patients
Build patient's head three-dimensional digitalization model；Determine that in the operation of upper jaw bone bone piece Virtual cropping, upper jaw bone bone piece exists
Excision and the direction of movement and distance is needed on three-dimensional；Then be given according to patient's upper jaw bone concrete form
Osteotomy site, osteotomy region and postoperative preferable upper jaw bone locus, the outer surface of preferable upper jaw bone；
Step 2, then according to virtual osteotomy position and osteotomy region, use cad technique to design upper jaw bone
Osteotomy guide entity, described osteotomy guide entity is made up of two, left and right parts, two component forms structure bases
This symmetry, is individually fixed in the former maxilla surface in left and right, the inner surface of osteotomy guide entity and former upper jaw bone table
Face fits tightly, and the outer surface form of osteotomy guide entity is determined by former maxilla surface form, and osteotomy is navigated
The outer surface of entity sets position hitching post, and osteotomy guide entity is fitted with maxilla surface and reaches the most stable
Fixing after position, osteotomy guide entity osteotomy district is provided with osteotomy labelling, excises osteotomy region by osteotomy labelling,
In digitized operation plan, three-dimensional osteotomy site and osteotomy region are stored in osteotomy navigation in the way of morphosis
In entity；
Step 3, then according to upper jaw bone remainder and be positioned at postoperative preferable upper jaw bone space bit after cutting
The upper jaw bone bone piece put uses what cad technique designed the upper jaw bone bone piece that need to move to relocate guide entity,
Described relocate guide entity inner surface and osteotomy guide entity outer surface, to be positioned at postoperative preferable upper jaw bone empty
Between the upper jaw bone bone piece surface of position fit tightly, relocate the guide entity preferable upper jaw bone of outer surface form
Outer surface determine, relocate guide entity top and be provided with that to position hitching post with osteotomy guide entity two corresponding
Two keyholes, relocate guide entity by two keyholes and form firm hitching post lock knot with osteotomy guide entity,
The upper jaw bone bone piece relocating guide entity and be positioned at postoperative preferable upper jaw bone locus is fitted and reaches only
Fix after one stable position, by making in digitized operation plan with upper jaw bone bone piece laminating form Design
Bone piece three-dimensional space position is stored in the way of morphosis and relocates in guide entity；
Step 4, finally according to osteotomy guide entity and the Digital Three-Dimensional geometric model that relocates guide entity,
Rapid prototyping technology is used to make overall navigation entity.
Individuation upper jaw bone osteotomy the most according to claim 1 and relocate the manufacturer of guide entity
Method, it is characterised in that osteotomy region described in step one refers to: after the upper jaw sections, if need to
Upper movement, it is necessary to remove a part and bone piece can be moved the bone producing stop, so that upper jaw bone bone piece energy
Enough move to required position smoothly.
Individuation upper jaw bone osteotomy the most according to claim 1 and relocate the manufacturer of guide entity
Method, it is characterised in that osteotomy guide entity non-osteotomy area top and upper jaw bone remainder table in step 2
Face laminating and be fixed as being drilled into few 2 holes, institute on osteotomy guide entity after reaching the most stable position
State at least 2 holes to fix with upper jaw bone surface of bone for osteotomy guide entity.
Individuation upper jaw bone osteotomy the most according to claim 1 and relocate the manufacturer of guide entity
Method, it is characterised in that osteotomy described in step 2 is labeled as accommodating the groove structure of electric saw blade, groove is tied
Structure coincide consistent with osteotomy line position and osteotomy amount.
Individuation upper jaw bone osteotomy the most according to claim 1 and relocate the manufacturer of guide entity
Method, it is characterised in that after relocating guide entity in step 3 and moving, upper jaw bone bone piece is fitted and reaches only
It is fixed as after one stable position being drilled into few 2 holes, described at least 2 holes on guide entity relocating
Fix for upper jaw bone bone piece after relocating guide entity and moving.
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| Application Number | Priority Date | Filing Date | Title |
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| CN201210012975.7A CN103202729B (en) | 2012-01-16 | 2012-01-16 | A kind of individuation upper jaw bone osteotomy and relocate the manufacture method of guide entity |
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| CN201210012975.7A CN103202729B (en) | 2012-01-16 | 2012-01-16 | A kind of individuation upper jaw bone osteotomy and relocate the manufacture method of guide entity |
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| CN104739513B (en) * | 2015-03-12 | 2017-04-12 | 徐贵升 | Method for producing human tissue simulated operation model and guide plate |
| CN105943113B (en) * | 2016-04-13 | 2018-05-25 | 南方医科大学 | A kind of preparation method of mandibular angle bone cutting navigation template |
| CN106725849B (en) * | 2017-01-17 | 2018-12-14 | 武汉大学 | A kind of fast conversion method of operation on mandible titanium plate-osteotomy guide plate spatial position |
| FR3063427B1 (en) * | 2017-03-03 | 2022-01-14 | Modjaw | DEVICE FOR MANDIBULAR FIXATION OF A LOCALIZATION MARKER |
| CN109124783B (en) * | 2017-06-19 | 2021-07-27 | 王旭东 | Manufacturing method of digital positioning guide plate in jaw deformity correction surgery |
| CN115300138A (en) * | 2020-03-12 | 2022-11-08 | 北京大学口腔医学院 | Computer aided design method for deciding orthodontic orthognathic combined treatment operation time |
| CN112148006B (en) * | 2020-09-17 | 2025-01-21 | 常州锦瑟医疗信息科技有限公司 | Path planning auxiliary adjustment device and control method |
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Effective date of registration: 20211115 Address after: No. 639, manufacturing Bureau Road, Huangpu District, Shanghai 200011 Patentee after: SHANGHAI NINTH PEOPLE'S HOSPITAL SHANGHAI JIAOTONG University SCHOOL OF MEDICINE Address before: The Ninth People's Hospital Affiliated to Jiaotong University Medical College, No. 639, manufacturing Bureau Road, Huangpu District, Shanghai 200011 Patentee before: Wang Xudong Patentee before: Li Biao |
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Effective date of registration: 20220628 Address after: Room 122, 2305 Zuchongzhi Road, China (Shanghai) pilot Free Trade Zone, Pudong New Area, Shanghai 201210 Patentee after: Zhengya Dental Technology (Shanghai) Co.,Ltd. Address before: 200011 No. 639, manufacturing Bureau Road, Shanghai, Huangpu District Patentee before: SHANGHAI NINTH PEOPLE'S HOSPITAL SHANGHAI JIAOTONG University SCHOOL OF MEDICINE |
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