Application Of Prefabricated Temporary Obturator Via 3D Printing Technique In The Prosthetic Restoration Of Anterior Maxillary Defect

Objective:Through using the prefabricated temporary obturator which is made via 3D printing technique,to achieve accurate and immediate restoration of the anterior maxillary defect.And to explore the applicative value of 3D printing technique in immediate prosthetic restoration of anterior maxillary defect,so as to provide preliminary exploration for improving the quality of life of maxillary defect patients.Method:A total of 3 cases of maxillary anterior defect caused by malignant tumor(Zhao Yimin's eight classification: class III)were selected from March 2017 to August 2017.All the patients were middle-aged and old women.Among them,one patients were immediately repaired after extended resection of the primary lesion.Another one case had no recurrence and metastasis after two years of operation.After the operation that the scar was repaired,immediately restored the defect.And the last one were repaired without recurrence or metastasis after two years of operation.All patients had good retention of maxillary teeth and mandibular teeth are in place or dentured.Through the spiral CT scan in patients with maxillofacial,we will deliever the DICOM data into Mimics software,the model of maxillofacial defects by image segmentation,3D reconstruction and remodeling of the defect area,the use of 3D printing technology,the design and implementation of prefabricated accurate,personalized temporary obturator and the disinfection,in order to complete therestoration.A model of the patient was made and a palatine plate was made to provide retention for temporary obstruction and routine disinfection.It is necessary for the patients to be designed to complete the operation according to the preoperative operation plan.After the operation,the prefabricated temporary obturator was put into the bone defect area to try to be worn and adjusted.The effect of the facial features recovery was good,the nasal cavity was separated and the surgical wound was protected.After the test is suitable,the palatine plate is made before the operation,so that it can get a good retention effect.After 2 weeks of disassembly,a formal prosthesis was made,and an impression was made in the case of a prefabricated temporary blocker and the prosthesis was completed.The lip radians of prefabricated temporary obturators are fully preserved during the process of fabrication to achieve the same repair effect as pre-operative design.The patients not need surgery to temporary prefabricated obturator caused by bone defect try to adjust,make facial restoration effect while good separation of oral and nasal cavity.After the test is suitable,wear the palate plate to make it get a good retention effect.After wearing for 2 weeks,the patients showed that they had basically adapted to the obstructing device.There was no discomfort in the area.After examination,the oral mucosa was not red and swollen,and there was no tender point during the mastication,so the formal prosthesis was prepared.In the case of prefabricated prosthesis,the impression was made and the formal prosthesis was completed.The lip arc of the prefabricated temporary stopper is fully preserved in the process of fabrication to achieve the same repair effect as the design.After the restoration,we observed the change of facial features,the clearance of voice and mouth cavity closure.Patients should pay more attention to postoperative wound bleeding and infection.Result:All the 3 patients completed a temporary obturator and made a formal prosthesis.There were no bleeding and infection after operation in the 2 patients after operation.A formal prosthesis was made after disassembly.There was no obvious scar contracture,no limited opening,but clear speech and good facial feature.The recovery of the fullness of the facial feature was ideal and the pronunciation was clear in the cases of non operated patients.After 1 years of postoperative follow-up,all patients insisted on wearing prosthetic prostheses.At the same time,the patient that doing restoration and resection at the same time occurred 3 months after tumor resection and repair.The remaining two patients had no recurrence after operation.All patients were satisfied with the effect of repair,psychological and emotional stability.Conclusion:1?3D printing to construct the full range of shows the lesion and bone defects,and accurately reflects the implant morphology to complete the precise prefabricated prosthesis personalized,in vitro,the recovery of patients with facial and physiological function,realize the true sense of the surgical model the.The accurate and personalized prefabricated prosthesis can restore the shape of the patient early,and improve the patient's satisfaction.It has certain clinical significance for the repair of maxillofacial bone defects.2 ? In order to achieve immediate postoperative restoration and achieve the desired restoration effect,we need close cooperation between surgeons and surgeons.