Clinical Research On The Accurate Repair Of Mandibular Defects By Computer Aided Technique

Purpose① To explore the influence of the structural of the temporomandibular joint after mandible reconstruction by computer aided technology.② To analysis the epidemiology differences of the temporomandibular disorders between patients with obstructive sleep apnea hypopnea syndrome and normal people.Methods OF twenty-six patients were admitted from January 2014 to November 2017 who underwent mandible reconstruction because of the mandibular tumor in our hospital,Eight patients surgically reconstruction by computer aided technical(digital reconstruction group),and 18 patients surgically reconstruction by traditional methods(control group),all patients with maxillofacial three-dimensional spiral CT examination pre-and postoperative,Temporomandibular joint space,linear ratio,the linear distance and Angle related to mandibular morphology were measured pre-and postoperative with the Mimics 19.0 software,statistical analysis was performed using SPSS 17.0 software package.Results① There was no significant difference of anterior and posterior temporomandibular joint space,angle between the condyle transverse axis and the median line in the digital reconstruction group(P>0.05),but statistical difference of the anterior joint space(P<0.05).There was statistically significant difference in the control group(P<0.05).There was no statistically significant difference of preoperative joint space between the two groups(P>0.05),After the operation,there was no statistical significance in the anterior joint space(P>0.05),but significant difference of post-operative superior and posterior temporomandibular joint space(P<0.05).There was no preoperative condyle displacement between the two groups and no statistical significance of post-operative condylar position(P>0.05).There were 1 cases(12.5%)of post-operative with anterior transposition of the joint in the digital reconstruction group,but 6 cases(33%)in the control group.②The deviations of intergonion distance of the computer aided and conventional surgery group were 3.02±1.46 mm and 4.91±2.09 mm,respectively(P<0.05),The deviations of gonial angle of the computer aided and conventional surgery group were 3.20 ° ± 1.17 ° and 6.76 ° ± 4.70°,respectively(P<0.05),there were statistically significant differences between the two groups.There were no significant difference in the mandibular ramus length,mandibular body length,intercondylar distance,anteroposterior distance,sagittal mandibular angle between the two groups(P>0.05),but in the digital reconstruction group,the deviation of each measurement data was reduced compared with the conventional surgery group.Conclusion① Computer aided technology can effectively improve the predictability of the surgical procedure in the reconstruction of mandibular defects,precise restoration the mandible morphology and condylar position,improve the effect of reconstruction.③ The application of computer aided technique in mandible reconstruction can effectively improve the accuracy of mandible reconstruction and restore the maxillofacial morphology.