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研究生:盧韋勳
研究生(外文):Wei-shiun Lu
論文名稱:快速成型技術應用於口腔顎面外科醫療之研究
論文名稱(外文):The Study of Applying Rapid Prototyping Technology in Oral and Maxillofacial Surgery
指導教授:鄭逸琳
指導教授(外文):Yih-Lin Cheng
口試委員:鄭逸琳
口試日期:2011-07-15
學位類別:碩士
校院名稱:國立臺灣科技大學
系所名稱:機械工程系
學門:工程學門
學類:機械工程學類
論文種類:學術論文
論文出版年:2011
畢業學年度:99
語文別:中文
論文頁數:130
中文關鍵詞:快速成型技術影像處理電腦斷層掃描口腔及顱顏面創傷
外文關鍵詞:Rapid Prototyping techniqueimage processingComputed Tomographyoral and craniofacial trauma
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目前對於口腔及顱顏面受到創傷的病患,常因為無法有效評估骨折移位,檢查咬合狀態,並取其牙模重建評估,使得在整個醫療處理過程受到侷限,並影響到病患後續的復原。又因牙齒的咬合狀態需精準配合,顎骨模型的精度於臨床應用上有嚴格之要求。因此,本研究利用電腦斷層掃描,搭配影像處理和快速成型技術,基於不二次傷害病患口腔及顱顏面組織的情況下,製作出病患完整的上下顎骨模型,以供術前規劃模擬之用。
本研究首先建立顱顎生物模型的一般製作流程,將電腦斷層掃描影像,透過商用醫學影像處理軟體,轉成CAD檔案,再使用快速成型技術製作出顎骨模型。與實體比對,發現誤差量約在1~2mm,未能達到臨床應用1mm以下之需求。透過誤差來源的分析,針對流程中可能的誤差如CT層厚差距、影像閥值選取與編輯、RP模型製作等,加以探討改善,進而訂定一套新的標準流程,製作出精度較高的實體模型,平均誤差可降至0.25mm。此外,亦將此標準流程應用於8個實際病例,平均誤差在0.3mm以下,證實可成功代替牙模型之使用。本研究所產生的高精度生物模型,將有助於提高手術成功率及安全性,降低手術後併發症及節省治療時間與醫療成本,為口腔顎面創傷的病患,提供新的醫療選擇,亦可推廣於其他類似的應用。
Most oral and craniofacial trauma patients cannot have their fracture displacement assessed effectively, neither can they examine their occlusion nor re-evaluate their dental cast. This restricts the whole medical process and influences the recovery of the patients. Besides, occlusion requires accurate functional contact, thus the accuracy of the maxillofacial model needs to meet strict clinical demands. Therefore, in this research, we attempt to get the complete maxillofacial model of patients without damaging the oral and craniofacial tissues of patients by using computed tomography (CT) along with image processing and rapid prototyping (RP) technique.
At first, a set of procedures of generating maxillofacial model was developed. CT images were segmated and converted to a CAD file by a commercial mdeical image processing software. RP technique was used to fabricate maxillofacial model. After comparison, the deviations were around 1-2mm, which did not meet clinical demands of less than 1 mm. After analying the sources errors, issues of CT slice thickness, image’s throushold selection and editing, and RP fabrication were investigated to improve the accuracy. As a result, new standard procedures were suggested to obtain RP maxillofacial models with higher accuracy. The improved average deviation can be reduced to 0.25mm. Furthermore, the new procedures were applied to 8 actual cases, and the average error was less than 0.3mm. This proves the RP maxillofacial models can replace the role of dental cast. The biological RP models with high accuracy generated in this research can improve sucess rate and safety in a surgery. It can also reduce complications after the surgery, as well as the time of treatment and medical cost. It provides the oral and maxillofacial trauma patients a new medical option, and can be applied to other similar applications.
摘要 I
Abstract II
誌 謝 IV
圖目錄 VIII
表目錄 VIIII
第一章 緒論 1
1.1 前言 1
1.2 研究動機及目的 2
1.3 研究方法 3
1.4 論文架構 4
第二章 文獻探討 5
2.1 顱顏顎面之構造 5
2.1.1 上顎骨構造 7
2.1.2 下顎骨構造 8
2.1.3 牙齒結構 9
2.1.4 顏面神經 11
2.2 放射技術 12
2.2.1 3D(立體式)影像 13
2.2.2 CT影像於醫學工程的應用 14
2.3 快速原型技術 17
2.4 快速成型用於實體模型與手術導引製作 24
2.4.1 人工植牙 24
2.4.2 手術模板 24
2.4.3 其他應用 25
第三章 顏面顎骨生物模型製作流程 32
3.1 顏面顎骨之製作流程 32
3.2 顏面顎骨CAD模型之建立 33
3.3 顱顏顎面骨之模型製作 44
3.3.1 OBJET EDEN 330快速原型系統規格 44
3.3.2 OBJET EDEN 330快速原型機製作過程流程 46
第四章 誤差分析與標準流程訂定 50
4.1 顱骨尺寸比對 50
4.1.1 測量基準 51
4.1.2 顱顏面顎骨模型製作結果 54
4.1.3 實驗組頭顱骨 55
4.1.4 頭顱骨數據討論 56
4.2 誤差分析 56
4.2.1 電腦斷層掃描誤差 57
4.2.2 影像處理誤差 59
4.2.3 3D重建誤差 59
4.2.4 RP系統誤差 60
4.3 誤差實驗 60
4.3.1 CT層厚差距比較 61
4.3.2 閥值選取 63
4.3.3 手工編輯誤差 71
4.3.4 金屬散射誤差 72
4.3.5 快速原型機模型製作誤差 75
4.4 Dental CT與CT差距 76
4.5 標準操作流程 79
4.6 重製面顎骨 81
第五章 案例報告 86
5.1 一般CT影像病例 86
5.1.1 Case 1 86
5.1.2 Case 2 91
5.1.3 Case 3 94
5.2 Dental CT影像病例 97
5.2.1 Case 4 97
5.2.2 Case 5 99
5.2.3 Case 6 101
5.2.4 Case 7 102
5.3 臨床案例應用 104
第六章 結論與未來方向 106
6.1 結論 106
6.2 未來方向 107
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