目的 本研究拟运用3D打印技术预制新西兰兔颅面骨个体化钛合金修复体,在进行颅骨缺损精准修补后,探讨钛网植入是否干扰新西兰幼兔颅面骨的生长和发育。方法 12只幼年新西兰兔被纳入研究,制备颅骨缺损模型,通过螺旋CT薄层无间距扫描获得断层数据,构建三维颅骨立体模型,利用3D辅助技术进行修复体的三维模型制造,结合重建模型,利用个体化钛修复体及钛钉固定进行颅骨缺损修补。在钛修复体植入手术后16周时处死兔子,留取标本,通过逐层分离、剥除充分暴露颅骨面,测量双侧各骨性标记点的距离并进行统计学分析。 结果 钛修复体植入侧额骨眶部发育较对侧显著迟缓(P<0.05);植入侧颅骨长径明显短于对侧(P<0.01);左右两侧颅骨的高度之间也存在显著性差异(P<0.01),且修复体植入处术前、术后各骨性标记点距离均存在统计学差异(P<0.05)。结论 个体化钛修复体及钛钉固定修补幼年新西兰兔缺损的颅骨后,阻碍了修补侧颅面骨的生长发育,造成了修补侧及对侧颅面骨的不对称畸形发育。在临床中运用钛网进行儿童及婴幼儿颅骨缺损修补时需慎重选择。

Objective To use 3D printing technology to prefabricate titanium prosthesis and repair craniofacial bones of New Zealand rabbits, and investigate whether the implantation of titanium mesh interferes the growth and development of craniofacial bones of rabbits.Methods Twelve young New Zealand rabbits were scanned by spiral CT thin-film non-pitch scanning to obtain tomographic data for the construction of 3D skull model.3D prototype of prosthesis was created with 3D printer.Titanium alloy restorations and titanium screws were used to repair the defect area.Rabbits were sacrificed 16 weeks after titanium prosthesis implantation.Skull surface was exposed through layer-by-layer separation and stripping and the distance between bilateral bony markers was measured for statistical analysis.Results The development of the frontal bone orbital part of titanium prosthesis was significantly delayed compared with that of the contralateral side (P<0.05), and the long axis of the implanted skull was significantly shorter than that of the contralateral side (P<0.01).There were also significant differences between the left and right cranial heights (P<0.01) and between the distances of preoperative and postoperative bone markers (P<0.05).Conclusion Individualized titanium prosthesis and titanium nail fixed repair hinder the craniofacial bone growth and development of young rabbits, resulting in repair side and contralateral craniofacial bones asymmetry development.Using titanium mesh for skull defect repair of children and infants should be careful.