三维数字化扫描及测量技术在下颌前突畸形诊治中的应用

摘要

背景：下颌前突畸形经典的正颌外科修复方案包括术前的头影测量，取模，面弓转移，模型外科，制做牙合板等过程，其流程繁琐复杂且往往容易存在偏差，修复后的难以预估更是一直困扰医生与患者沟通时的一大难题。　　目的：对近年来数字化三维扫描技术在下颌前突畸形临床诊治中的应用现状进行综述，阐述其原理、应用及优缺点，为临床使用提供参考。　　方法：于2015年9月以“三维扫描，骨性Ⅲ类，正颌，下颌前突”为中文关键词，以“three-dimensional scanning，classⅢ，orthognathic，mandibular prognathism”为英文关键词，采用计算机检索万方医学网和PubMed数据库，筛选有关三维扫描技术在下颌前突畸形诊治中的应用文章48篇进行分析。　　结果与结论：三维扫描技术在对下颌前突畸形患者修复前的诊治具有较传统测量技术所不具备的高精确度、耗时短的特点，并能直接实时采集捕捉物体的三维几何形状，进行体表器官解剖形态建模，采集、测量体表生物信息数据，为修复后的评估以及随访提供了可靠的监测方法。与 CT 相比，三维扫描技术无法显示扫描物的内部结构，无法分离软硬组织层次，因而在临床使用中需根据数据需求合理选用。%BACKGROUND:Aclassical orthognathic schemefor mandibular prognathism includespreoperative cephalometric analysis,acquiring modulus, facebow transfer, modelsurgery, making occlusion plate.This process is cumbersome,complex,andproneto have bias. Moreover, orthognathic effects are difficult to be predicted, which is a majordifficultyindoctor-patientcommunication. OBJECTIVE:To summarize and analyze the use of three-dimensional scanning techniques in the treatmentand diagnosisof mandibular prognathism, including principle, application and relative merits, thusprovidingreference forapplying to theclinic. METHODS:Papers addressing the use of three-dimensional scanning techniques in thediagnosisand treatment of mandibular prognathism were retrieved by computer in Wanfang and PubMed databases with the key words of “three-dimensional scanning, class III,orthognathic, mandibular prognathism” in Chinese and English, respectively. A total of 48papers were included for review. RESULTS AND CONCLUSION:Compared with the traditional technology,the three-dimensional scanning technology has high accuracy and efficiency in the diagnosis and treatment of mandibular prognathism, and candirectlycapture the 3D geometry of objects for modeling, colection and measurement of biological data, which provides a reliable monitoring method for postoperative assessment andfolow-up. Compared with the CT,thethree-dimensional scanning technology cannot show the internal structure and separate hard and soft tissues, which should be reasonably chosen according to practical data.