| Objective:Through 3D printing mandible model experiment,Comparing the positioning and accuracy of fenestration surgery with dynamic navigation assisted fenestration surgery for jaw cyst and traditional surgical methods,compared preoperative design window location and postoperative bone window position deviation,verify the dynamic navigation system in the jaw cyst surgery included surgical precision of the clinical application,To verify the accuracy of the dynamic navigation surgical system in the clinical application of mandible cyst fenestration surgery,and to provide a reference for maxillofacial surgeons in the clinical diagnosis and treatment of surgical plan and selection of hard surgical auxiliary technology.Methods:(1)Based on Computed Tomography(CT)data of the mandible of a patient with odontogenic mandibular cyst in Wuzhou Red Cross Hospital,3d reconstruction of the mandible model was performed by Mimics and other software.Thirty identical jaw models were printed,which were divided into two groups:group A(15 patients)underwent fenestration using dynamic real-time navigation technology,and group B(15 patients)underwent fenestration using traditional surgical methods.(2)Before surgery,surgical navigation design software was used to design the surgical plan for the ideal location,shape and aperture size of the jaw cyst model.During the operation,the two groups were operated with dynamic navigation assisted fenestration and traditional free hand fenestration respectively according to the same surgical design.After surgery,CT data of the jaw model were collected,and the CT was imported into Mimics19.0 software for 3D reconstruction.Then,the accuracy of the postoperative CT and the preoperative CT virtual bone window position on the jaw were compared.(3)Software was used to measure the center offset distance,bone window overlap area and area overlap rate of the actual bone window opening position and the bone window opening position designed before surgery of the two groups respectively.Repeated measurements were made three times and the average value was taken.SPSS21.0 was used to record data,and the two groups of data were statistically analyzed by quantitative independent sample T test.When P<0.05,the deviation was statistically significant.Results:(1)The deviation of the bone window opening center point in the dynamic real-time navigation group was(0.909±0.133)mm,and that in the traditional surgery group was(2.163±0.786)mm,the difference was statistically significant(P<0.05).(2)The bone window overlap area was(21.923±2.228)(mm)~2in the dynamic real-time navigation group and(16.633±2.457)(mm)~2in the traditional surgery group,and the difference was statistically significant(P<0.05).(3)The bone window area overlap rate of the dynamic real-time navigation group was(77.54±7.88)%,and that of the traditional surgery group was(58.83±8.69)%,the difference was statistically significant(P<0.05).Conclusion:(1)Through the experimental study of 3D printed jaw model,this study preliminarily confirmed that the accuracy of windowing surgery assisted by dynamic navigation technology for jaw cyst is different from that of traditional surgical methods.The surgical method guided by dynamic navigation has less deviation and higher accuracy.(2)For the fenestrated surgery of jaw cyst,especially in the special cases where the fenestrated site is close to the important anatomical structure,such as the inner tooth root,nerve vessels,maxillary sinus or jaw cyst with deep location,it is safer to use dynamic navigation assistance technology for real-time surgical localization.(3)This experimental study can confirm that in vitro model of dynamic navigation assistance technology can have a certain guiding significance in the application of maxillary cyst fenestration surgery. |
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