基于新鲜人颌骨切割力、热特性的低损伤锯切机理与临床应用研究

Maxillofacial plastic surgery is the main treatment for congenital or acquired craniofacial malformation diseases, and low-damage jaw cutting is very important for patients’ safety and good healing after operation. This project will do the basic theories and clinical application study on maxillofacial bone damage during surgery. Firstly, based on the engineering testing methods, bone sawing forces and temperature variation on different jaw bones by different structural bone saws(reciprocating saw, piezosurgery) will be studied, and it will provide a theoretical guidance and technical support for independent intellectual property rights of the domestic maxillofacial bone saw devices. And then, based on the histology, mechanics of composite materials, biological feature recognition, and other theories, the critical temperature model of bone cutting damage will be established. Finally, by the clinical evaluation of maxillofacial bone sawing surgery, low-damage optimized operation path will be acquired, and the operation specification of maxillofacial surgery will be established. This project aims to cross medical engineering research, the future achievements will help to improve the operation specification of maxillofacial bone sawing surgery, provide a technical guidance for bone sawing medical equipments with completely independent intellectual property rights, and it is expected to fill the domestic blank.

颌骨锯切整复手术是治疗先天性或获得性颅颌面畸形疾病的主要手段，实现颌骨的低损伤锯切对术区安全和术后良好愈合具有十分重要的意义。本项目将针对颌面整复手术过程中颌骨组织损伤机理开展基础理论与应用研究，首先应用工程测试手段，研究不同结构骨锯（来复锯、超声骨锯）对不同颌骨组织的锯切力、温度变化规律，为开发具有自主知识产权的国产颌面骨锯器械提供理论指导和技术支持；然后基于组织学、复合材料力学、生物特征识别学等理论，建立基于锯切温度的颌骨组织临界损伤模型；最后通过颌骨整复手术临床术后评价，获得低损伤颌面整复手术优化锯切路径，建立完善颌面整复手术操作规范。本项目着眼医工交叉多学科合作研究，未来成果有助于完善颌骨锯切手术操作规范，为研发出具有完全自主知识产权的颌骨锯切医疗器械提供技术指导，有望填补国内空白。

本项目基于医工结合研究方式，应用工学研究方法，定量的、可重复的、客观的采集新鲜人尸体颌骨的切削力，得出骨皮质厚度、切削进给速度、切割频率、钻头转速、骨密度等相关因素之间的回归方程，初步实现了虚拟正颌手术培训系统中的力反馈功能。本项目研究内容包括探究颌骨低损伤的锯切机理，通过研究颌面整复手术过程中的力、热特性及其对颌骨组织的损伤机制，为临床手术路径规划提供依据，并获得面向不同患者群体的低损伤手术方案；通过对不同类型颌骨手术器械的锯切效果评价，为国产医疗器械开发提供技术支持。

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