CN-122005001-A - Series osteotomy guide plate for condylar osteotomy and manufacturing method thereof

CN122005001ACN 122005001 ACN122005001 ACN 122005001ACN-122005001-A

Abstract

The invention discloses a series of osteotomy guide plates for a condylar osteotomy and a manufacturing method thereof, and relates to the technical field of medical appliances. The manufacturing method comprises the steps of manufacturing an anhydrite tooth model, establishing a virtual three-dimensional craniomaxillary model, obtaining virtual dentition data, replacing the dentition data in the three-dimensional data, determining a target position of a mandibular dental bone segment, planning and virtually designing coracoid resection and condyloid resection osteotomy lines, virtually resecting a patient side coracoid process and a condyloid process, virtually designing a patient side temporomandibular joint reconstruction process to obtain a patient side ascending branch three-dimensional model, drawing a coracoid bone resection guide plate, drawing a condyloid bone resection guide plate based on the shape and the osteotomy line position of the mandible, and three-dimensionally printing the guide plate. By adopting the method, the guide plate can be fixed by using the shape of the guide plate without additional fixing measures, so that the operation difficulty is reduced, the operation time is shortened, the accuracy of condylar resection is improved, and the possibility of design errors caused by matching and fusion of multiple data in the digital design process is reduced.

Inventors

HE WEI
LEI JIE
WANG LIN
WANG XIAOXIA
LI YANG

Assignees

北京大学口腔医学院

Dates

Publication Date: 20260512
Application Date: 20260409

Claims (10)

1. A method for manufacturing a series of osteotomy guides for a condylar osteotomy, the osteotomy guides comprising a coracoid osteotomy guide and a condylar osteotomy guide, the method comprising the steps of: performing spiral CT scanning on the maxillofacial region of a target object, collecting three-dimensional data of the craniomaxillofacial region and teeth, and manufacturing an anhydrite tooth model; importing the three-dimensional data into craniomaxillofacial surgery planning software to establish a virtual three-dimensional craniomaxillofacial model; scanning the anhydrite tooth model by laser to obtain virtual dentition data, and replacing the virtual dentition data in the three-dimensional data; simulating a target operation type on the virtual three-dimensional craniomaxillary model, and determining a target position of the mandibular dental bone section based on a final occlusion relationship; on a Computed Tomography (CT) image, planning and virtually designing coracoid resection and condyloctomy osteotomy lines according to the range of condyloid lesions, virtually resecting the coracoid and condyloid of an affected side, upwards moving the ascending branch of the affected side, and virtually designing the reconstruction of the temporomandibular joint of the affected side by using the residual end of the condyloid so as to obtain a three-dimensional model of the ascending branch of the affected side; Importing the virtual three-dimensional craniomaxillofacial model of the target object and the affected side branch three-dimensional model file into three-dimensional design software; drawing a coracoid osteotomy guide plate of a first target thickness and a first target upper edge width between a mandibular ascending branch leading edge and an sigmoid notch based on an outer surface morphology of the affected side mandibular ascending branch and a position of a coracoid osteotomy line; Performing Boolean operation between the coracoid osteotomy guide plate and the outer surface of the mandibular ascending branch to generate the inner surface of the coracoid osteotomy guide plate; Drawing a condylar osteotomy guide of a second target thickness and a second target width based on the morphology of the resected coracoid mandible and the osteotomy line position of the condylar osteotomy; performing Boolean operation between the condylar osteotomy guide plate and the outer surface of the mandible to generate the inner surface of the condylar osteotomy guide plate; Three-dimensionally printing the coracoid osteotomy guide plate and the condylar osteotomy guide plate to produce the osteotomy guide plate.
2. The method for manufacturing a series of osteotomy guides for a condylar osteotomy of claim 1, wherein the step of mapping the coracoid osteotomy guide of the first target thickness and the first target upper edge width between the anterior edge of the mandibular elevator and the sigmoid incision based on the external surface morphology of the affected mandibular elevator and the position of the coracoid osteotomy line, specifically comprises: Drawing a coracoid osteotomy guide plate of the first target thickness between a mandibular ascending branch leading edge and an sigmoid notch based on an outer surface morphology of the affected side mandibular ascending branch and a position of a coracoid osteotomy line; And keeping the upper edge of the coracoid osteotomy guide consistent with the coracoid osteotomy line of virtual design, drawing the upper edge of the coracoid osteotomy guide with the width of the first target upper edge, and preventing the front edge and the rear edge of the coracoid osteotomy guide from extending to the inner side of the mandibular ascending branch.
3. The method of manufacturing a series of osteotomy guides for a condylar osteotomy of claim 1, wherein in the step of mapping the coracoid osteotomy guide between the anterior edge of the mandibular elevator and the sigmoid notch based on the outer surface morphology of the affected side mandibular elevator and the position of the coracoid osteotomy line, the first target thickness is 0.80-1.20 mm.
4. A method of manufacturing a series of osteotomy guides for a condylar osteotomy as in claim 2 or 3, wherein in the step of mapping the coracoid osteotomy guides between the anterior edge of the mandibular lift and the sigmoid incision based on the external surface morphology of the affected side mandibular lift and the location of the coracoid osteotomy line, the first target upper edge width is between 0.80 and 1.20 cm.
5. The method for manufacturing a series of osteotomy guides for a condylar osteotomy as in claim 1, wherein the step of mapping the second target thickness and the second target width of the condylar osteotomy guide based on the morphology of the resected coracoid mandible and the osteotomy line position of the condylar osteotomy specifically comprises: drawing a condylar osteotomy guide plate of the second target thickness based on the morphology of the resected coracoid mandible and the osteotomy line position of the condylar osteotomy, starting from the ascending branch front edge, covering posteriorly the coracoid stump, the sigmoid notch and the condylar neck front edge; Leading the front edge of the condylar osteotomy guide plate to be positioned at the front edge of the mandibular ascending branch, covering the front edge of the neck of the condylar process by the rear edge, enabling the upper edge to be consistent with the condylar osteotomy line, and drawing different parts of the condylar osteotomy guide plate with the second target width.
6. The method of manufacturing a series of osteotomy guides for a condylar osteotomy of claim 1, wherein in the step of mapping the second target thickness and the second target width of the condylar osteotomy guide based on the morphology of the resected coracoid mandible and the osteotomy line position of the condylar osteotomy, the second target thickness is 0.80-1.20 mm.
7. The method of manufacturing a series of osteotomy guides for a condylar osteotomy of claim 5 or 6, wherein in the step of mapping the condylar osteotomy guides of a second target thickness and a second target width based on the morphology of the resected coracoid mandible and the osteotomy line position of the condylar osteotomy, the second target width is 15-20 mm.
8. The method of manufacturing a series of osteotomy guides for a condylar osteotomy of claim 1, wherein in the step of three-dimensionally printing the coracoid osteotomy guide and the condylar osteotomy guide to manufacture the osteotomy guide, the coracoid osteotomy guide and the condylor osteotomy guide are both of a resin or nylon material.
9. The method of manufacturing a series of osteotomy guides for a condylar osteotomy of claim 1, wherein in the step of simulating a target surgical type on the virtual three-dimensional craniomaxillary model, determining a target position of a mandibular dental bone segment based on a final occlusion relationship, the target surgical type includes a Le Fort type I osteotomy, a mandibular sagittal split.
10. An osteotomy guide made by the method of making a series of osteotomy guides for a condylar osteotomy as in any one of claims 1-9.

Description

Series osteotomy guide plate for condylar osteotomy and manufacturing method thereof Technical Field The invention relates to the technical field of medical appliances, in particular to a series of osteotomy guide plates for a condylar osteotomy and a manufacturing method thereof. Background In recent years, digitization techniques have been widely used in the orthognathic surgical field. For patients with hemiside jaw fat malformation, digital data can be acquired before operation, then virtual design is carried out on orthognathic operation of the patient in a computer, meanwhile, CT images of the patient are combined, a condylar resection osteotomy line is determined in the calculation, and a scheme of temporomandibular joint reconstruction is further virtual designed. After the digital scheme is designed, the osteotomy scheme of the virtually designed condylar resection is converted into an intraoperative method, and two methods of surgical navigation, surgical guide plates and the like are mainly adopted at present. The navigation method has the defects of complicated steps, actual delay in operation, possible data drift in operation and the like, so the current navigation method is relatively rarely used, and the operation guide plate is more commonly used. The existing guide plates mainly have two types: 1) An extra-oral (pre-tragus) approach condylar resection guide plate. On the basis of completing the orthognatic virtual design of the patient with the semi-lateral jaw fat large deformity, a certain scholars designs a condylar bone cutting guide plate suitable for an tragus front approach according to the range of the condylar bone cutting, and uses the guide plate to be matched with a pre-bent titanium plate to complete the orthognatic operation and the condylar bone cutting operation at the same time. The main disadvantage of using such guide plates is that the use of an otologic approach can leave scars. In addition, the guide plate is positioned at the neck of the condyle, and the contact area between the guide plate and the bone is small, so that the guide plate is positioned by using additional titanium nails to conveniently finish the operation. 2) An intraoral access condylar resection guide. Because the operation field of intraoral access condyloctomy is relatively narrow, the requirements on clinical experience and operation skills of doctors are high, and therefore, the guide plate is less common at present. The guide plate designed by a certain learner is based on the design of the coracoid guide plate, and further designs a condylar bone cutting guide plate which extends backwards from the rising branch front edge and upwards to the condylar neck along the inner side of the rising branch. The guide plate is manufactured by adopting metal titanium three-dimensional printing, the thickness can be as thin as possible, but the rising support front edge and the rising support inner side of the jaw contact surface are flat, so that additional titanium nails are required to be fixed, and the position of the guide plate can be ensured to meet the design requirement. This, however, clearly increases the difficulty of the procedure, which is time consuming and generally accurate for condyloctomy. Based on this, there is a need to design a guide plate for condylar resection without additional fixation means to reduce the difficulty of the procedure, reduce the operation time, and improve the accuracy of the condylar resection. Disclosure of Invention The invention mainly aims to provide a series of osteotomy guide plates for a condylar osteotomy and a manufacturing method thereof, and aims to reduce the difficulty of the operation, reduce the operation time and improve the accuracy of the condylar resection. In order to achieve the above object, the present invention provides a method for manufacturing a series of osteotomy guides for a condylar osteotomy, the osteotomy guides including a coracoid osteotomy guide and a condylar osteotomy guide, the method comprising the steps of: performing spiral CT scanning on the maxillofacial region of a target object, collecting three-dimensional data of the craniomaxillofacial region and teeth, and manufacturing an anhydrite tooth model; importing the three-dimensional data into craniomaxillofacial surgery planning software to establish a virtual three-dimensional craniomaxillofacial model; scanning the anhydrite tooth model by laser to obtain virtual dentition data, and replacing the virtual dentition data in the three-dimensional data; simulating a target operation type on the virtual three-dimensional craniomaxillary model, and determining a target position of the mandibular dental bone section based on a final occlusion relationship; on a Computed Tomography (CT) image, planning and virtually designing coracoid resection and condyloctomy osteotomy lines according to the range of condyloid lesions, virtually resecting the coracoid and condyloid of an aff