A kind of individuation upper jaw bone osteotomy and relocate the manufacture method of guide entityTechnical 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 againThe 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 shapingOperation 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 deviationFormula is surgical operation therapy, by reorientating upper and lower jawbone bone piece, makes that patient's looks are attractive in appearance to be changedKind.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 dentitionType is transferred and resettled on half adjustable jaw frame.By design and the making of model surgery, respectively in mobile representativeThe plaster model of mandibular bone bone piece determines that jawbone bone piece needs the locus moved to, and makes mouth guardUse in art.This process needs to expend substantial amounts of manpower and time, and there is many potentialitiesError.When these errors all can cause performing the operation, jawbone bone piece can not reach the most optimal locus, fromAnd affect the improvement that patient's looks are attractive in appearance.Operation is controlled by mouth guard the position of jawbone bone piece, has steadyThe shortcomings such as qualitative difference and complex operation.Conventional surgical treatment in, the position of osteotomy and need remove bone piece manyIn 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 fieldApplication.Doctor can be according to the three-dimensional digital model of patient CT data's reconstruction patients head, in a computerCarry out virtual operation by Computer assisted surgery, bone piece is blocked and moves.By to differenceThe simulation of operation plan and comparing, finally determines optimal surgical planning.But these digitized operation metersDraw and be difficult to be converted to the concrete operations of actual guided operation doctor in art exactly.At present conventional by preoperative numberIt 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.；BehaviourMake process numerous and diverse, often need to repeatedly registrate and position.And the surgical navigation technology space bit to a single point at presentPut and determine more maturation, the structure of form so complicated for cranium jawbone bone piece, still can not carry out good skyBetween position.In the problem that surgical navigation technology self is deposited simultaneously, real-time error during as registrated in art and artThe problems such as tissue displacement all remain to be further improved.Factors above all limits extensively pushing away of surgical navigation technologyWide 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 pointThe manufacture method of location navigation entity.The method is for this common cranium Maxillary region of deformitas maxillaris surgical plasticOperation, manufactures personalized surgical navigational entity by computer-aided design and rapid prototyping technology, specificallyGuided operation doctor's art operates, it is achieved upper jaw bone three-dimensional accurately osteotomy and bone piece three-dimensional accurately relocate, and makePreoperative 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 navigationThe 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 patientsPatient'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 threeDimension needs excision and the direction of movement and distance on direction；Then be given according to patient's upper jaw bone concrete form and cutThe 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 boneOsteotomy guide entity, described osteotomy guide entity is made up of two, left and right parts, two component forms structure basesThis 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 tableFace fits tightly, and the outer surface form of osteotomy guide entity is determined by former maxilla surface form, and osteotomy is navigatedThe outer surface of entity sets position hitching post, and osteotomy guide entity is fitted with maxilla surface and reaches the most stableFixing 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 morphosisIn entity；
Step 3, then according to upper jaw bone remainder and be positioned at postoperative preferable upper jaw bone space bit after cuttingThe 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 emptyBetween the upper jaw bone bone piece surface of position fit tightly, relocate guide entity outer surface form by the preferable upper jawThe outer surface of bone determines, relocates guide entity top and is provided with that to position hitching post with osteotomy guide entity two correspondingTwo keyholes, relocate guide entity and osteotomy guide entity by two keyholes and form firm hitching post and lockKnot, relocate guide entity be positioned at postoperative preferable upper jaw bone locus upper jaw bone bone piece laminating and reachFix after the most stable position, by making digitized operation side with upper jaw bone bone piece laminating form DesignIn 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 formerJawbone 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 artIn accurately present, upper jaw bone bone piece achieves in art and is accurately positioned, preoperative digitized operation meterThe 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 toRemove a part and bone piece can be moved the bone producing stop, so that upper jaw bone bone piece can move to smoothlyRequired position.
In step 2, osteotomy guide entity non-osteotomy area top is the most unique with the laminating of upper jaw bone remainder surfaceIt is fixed as after stable position on osteotomy guide entity, be drilled into few 2 holes, runs through guide entity, penetrateSurface 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 positionPut 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 positionIt is fixed as being drilled into few 2 holes on guide entity relocating, runs through guide entity and osteotomy guide entity and wearEnter 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 navigationThe manufacture method of entity, has the advantage that 1) present invention is according to osteotomy guide entity and relocates navigation in factThe Digital Three-Dimensional geometric model of body, uses rapid prototyping technology to make overall navigation entity, guides bone saw to pressThe osteotomy site formulated in preoperative digitization program and the accurate osteotomy of osteotomy amount, move to postoperative ideal space positionUpper jaw bone bone piece by mating maintenance with the laminating relocating guide entity, it is achieved upper jaw bone three dimensions essenceReally osteotomy and relocating, it is achieved the digitized of operation, simplification, precision and controlledization, substantially reducesOperating time, alleviates the misery of patient, achieves significant technological progress and good society and economic effectBenefit；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 makesWith simply, it is not necessary to other redundant equipments, it is possible to accurately guided operation doctor operation；4) this guide entity is permissibleAccurately preoperative digitized operation plan is converted in art reality, substantially increases operation precision, it is achieved warpTesting 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 patientsPatient's head three-dimensional digitalization model；Determine the operation of upper jaw bone bone piece Virtual cropping needs on three-dimensionalThe 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 resistanceThe bone of gear, so that upper jaw bone bone piece can move to required position smoothly.Accurately determine osteotomy regionPractical 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, unnecessaryGap, 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 boneOsteotomy guide entity, described osteotomy guide entity is made up of two, left and right parts, two component forms structure basesThis 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 tableFace fits tightly, and the outer surface form of osteotomy guide entity is determined by former maxilla surface form, and osteotomy is navigatedThe outer surface of entity sets position hitching post, and osteotomy guide entity and maxilla surface are fitted in the most stable positionFixing afterwards, osteotomy guide entity osteotomy district is provided with osteotomy labelling, excises osteotomy region, number by osteotomy labellingIn word operation plan, three-dimensional osteotomy site and osteotomy region are stored in osteotomy navigation in fact in the way of morphosisIn body.The purpose of osteotomy guide entity set in this step is to carry out osteotomy more accurately.First, cutBone guide entity and maxilla surface are fixing after being fitted in the most stable position, may during to avoid osteotomyThe displacement occurred.The most stable described position be osteotomy guide entity inner surface with former maxilla surfaceFit like a glove.Described being fixed as is drilled into few 2 holes on osteotomy guide entity, runs through guide entity, penetratesSurface of bone, is fixed up osteotomy guide entity with jawbone surface of bone with screw.Excise according to osteotomy labelling during osteotomyOsteotomy region, described osteotomy is labeled as accommodating the groove structure of electric saw blade, groove structure and osteotomy line positionCoincideing consistent with osteotomy amount, the groove structure in osteotomy region guides electric saw accurately to cut, thus improves operationAccuracy.The location relocating guide entity that location hitching post is next step on osteotomy guide entity surfaceBe 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 cuttingThe 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 emptyBetween the upper jaw bone bone piece surface of position fit tightly, relocate guide entity outer surface form by the preferable upper jawThe outer surface of bone determines, relocates guide entity top and is provided with that to position hitching post with osteotomy guide entity two correspondingTwo keyholes, relocate guide entity and osteotomy guide entity by two keyholes and form firm hitching post and lockKnot, relocate guide entity be positioned at postoperative preferable upper jaw bone locus upper jaw bone bone piece laminating and reachFix after the most stable position, by making digitized operation side with upper jaw bone bone piece laminating form DesignIn case, bone piece three-dimensional space position is stored in the way of morphosis and relocates in guide entity.In this stepThe guide entity that relocates designed according to cad technique first passes through two keyholes thereon with osteotomy navigation in factBody forms firm hitching post lock knot, after establishing the location relocating guide entity, then with move to postoperative idealLocus upper jaw bone bone piece laminating, after obtaining the most stable position by upper jaw bone bone piece with relocateNavigation body is fixed, and the most stable described position is the inner surface relocating guide entity and move to postoperative idealThe upper jaw bone bone piece outer surface of locus fits like a glove.Described being fixed as is drilled on guide entity relocatingFew 2 holes, run through guide entity and osteotomy guide entity and penetrate surface of bone, then using fastened by screw.By thisThe 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 formerJawbone 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 inRelocate bone piece three-dimensional space position determined by the digitized operation plan in guide entity in art accuratelyPresenting, upper jaw bone bone piece achieves in art and is accurately positioned, and preoperative digitized surgical planning scheme is accurateReally be converted to operation reality.In operation, bone saw can be guided to cut by preoperative formulation according to osteotomy guide entityThe accurate osteotomy of bone line, the upper jaw bone bone piece cut down is accurately positioned by relocating guide entity, preoperative numeralChange 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 thisThe restriction of invention, in this area, those skilled in the art can show that needs are made adjustment, in appended right according to realVarious deformation or amendment is made all in protection domain in the range of requirement.