顎顔面領域におけるCAD/CAM 技術を用いたカスタムメイド患者適合型体内固定用プレート

• Published in: 日本口腔外科学会雑誌 Vol. 69; no. 11; pp. 486 - 492
• Main Authors: 植野, 高章, 井上, 和也
• Format: Journal Article
• Language: Japanese
• Published: 公益社団法人 日本口腔外科学会 20.11.2023
• Subjects: チタン; 患者適合型体内固定用プレート; 積層造形技術
• ISSN: 0021-5163; 2186-1579
• DOI: 10.5794/jjoms.69.486

Recent innovations in three-dimensional additive manufacturing technology, such as 3D printers, are being applied in the medical field. In the orthopedic field, titanium joint prostheses are used for various parts such as knees, hips, elbows, and fingers. In the field of dentistry, it is also used in metal frameworks for dentures, crown-bridge prosthetics, and dental implants. Implant bone augmentation using SLM（Selective Laser Melting）titanium mesh plates designed and shaped based on patient CT data has been performed with good results. In August 2021, guidelines were established for the maxillofacial region. These guidelines are expected to lead to the development and clinical application of patient-adapted internal fixation plate that can be optimally adapted to the patient's unique skeletal structure, even in cases where maxillofacial continuity has been lost due to tumor, trauma, or congenital deformity. 　The manufacturing process for the patient-adapted internal fixation plate begins with three-dimensional imaging using CT or other methods. The bone defects are confirmed from the obtained DICOM（Digital Imaging and Communications in Medicine）data, and a surgical simulation is performed using CAD software to design the Patient-adapted internal fixation plate design. The surgeon and designer exchange opinions on the basic design and the position of the plate fixation with screws. The designed data is loaded into the CAM software, and the layout of the support and molding table is set up for the laminate molding. 　The design process and points to keep in mind during the process will be presented. The application of 3D additive manufacturing technology to the maxillofacial region is expected to become more widespread as an innovative medical technology that will enable the realization of the diversity sought by individual patients.