ABSTRACT
Objective:To explore the effect of digital technology and 3D printing technology combined with non-vascularized ilium bone in repairing post-traumatic bone defect in maxillary anterior area.Methods:A retrospective case series study was performed to analyze clinical data of 8 patients with severe bone defect in maxillary anterior area after trauma admitted to First Affiliated Hospital of Zhengzhou University from June 2013 to January 2018. There were 6 males and 2 females, with the age of 18-43 years [(31.9±9.0)years]. The maxillary bone was reconstructed before surgery by employing digital technology. The intercept range of ilium was determined according to the best form of defect to be recovered. Then the model and guide plate was printed out by employing 3D print technology. The titanium mesh was prebended on the model. The bone was extracted and Onlay bone grafting was performed according to the guide plate. The implant restoration was performed 6 to 9 months after operation, and porcelain crown restoration was performed 4 to 6 months later. The iliac bone survival and postoperative complications were detected 6 months after bone grafting. The near-middle-far and vertical bone elevation of the alveolar ridge as well as bone elevation of lip palatal were measured before implantation. The condition around the implants was observed 6 months after porcelain crown restoration. The visual analogue score (VAS) was used to evaluate the pain after iliac bone transplantation and implantation. The implant stability coefficient (ISQ) was applied to assess the stability of the implants on the day and 4 months after operation.Results:All the patients were followed up for 24-48 months [(33.3±9.7)months]. Eight patients with non-vascularized iliums were all survived. There was one patient with mild infection after bone grafting and one patient with gingival inflammatory hyperplasia after implantation, both of whom were healed after treatment. There was no obvious peri-implant inflammation or absorption of the grafted bone. The increase in height of the alveolar on the mesial and distal bone, vertical bone and labial-palatal bone was 30.28-39.67 mm, 9.58-11.32 mm and 2.06-7.41 mm, respectively. All the implants showed good osseointegration. The VAS after implantation was (3.4±0.7)points, significantly alleviated compared with the preoperational level [(7.3±2.0)points] ( P<0.05). The ISQ was 84.4±1.9 at postoperative 4 months, showing no significant difference from that on the day after operation (72.9±1.4) ( P>0.05). Conclusions:In repair of severe bone defect in maxillary anterior area after trauma, the digital and 3D printing technology combined with non-vascularized ilium can improve the survival rate of bone grafts. The implant restoration after operation can reduce pain, restore the patients' facial appearance and achieve satisfactory oral physiological function.
ABSTRACT
<p><b>OBJECTIVE</b>To evaluate the clinical effects on incomplete intestinal obstruction treated with the adjuvant therapy of acupuncture and moxibustion.</p><p><b>METHODS</b>Using the retrospective analysis, 80 patients of incomplete intestinal obstruction were divided into an observation group and a control group, 40 cases in each one. In the control group, the routine treatment was given, such as fasting, gastrointestinal decompression, parenteral nutrition, infection prevention with antibiotics and enema laxative. In the observation group, on the basis of the treatment as the control group, acupuncture was applied at bilateral Zusanli (ST 36), Shangjuxu (ST 37) and Xiajuxu (ST 39); moxibustion was used at left Yangchi (TE 4), Zhongwan (CV 12), Qihai (CV 6) and Guanyuan (CV 4). The treatment was given once a day, 30 min each time. The average days of treatment, the surgical transfer rate, the time to first flatus, the recovery time of defecation and the time of solid food intake were observed in the patients of the two groups.</p><p><b>RESULTS</b>The average days of treatment in the observation group was obviously less than that in the control group (<0.05). The surgical transfer rate in the observation group was obviously lower than that in the control group (<0.05). The time to first flatus, the recovery time of defecation and the time of solid food intake were all obviously earlier than those in the control group (all <0.05).</p><p><b>CONCLUSION</b>The adjuvant therapy of acupuncture and moxibustion achieves the significant therapeutic effects on incomplete intestinal obstruction, shortens the treatment duration and reduces the surgical transfer rate and the patient's economic burden.</p>