The car accident of Lin Zhiying's father and son has recently attracted widespread attention. According to media reports, Lin Zhiying may carry out "3D printing technology for face reconstruction".
Can this technology-sounding repair method restore the "ageless appearance"?
The reporter learned that 3D printing to help facial reconstruction has actually been used in clinical practice, but 3D printing "bone and tissue" directly implanted in the human body is still more in clinical exploration.
Jiangsu Stomatological Hospital (Affiliated Stomatological Hospital of Southern Medical University) has previously completed 3 cases of 3D printed mandibular implants.
Experts say the technology still has a long way to go before it becomes widespread.
Yangzi Evening News/Ziniu News reporter Yang Yan
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Fractured face goes to "stomatologist"
Many people think that if there is a fracture, they have to go to an orthopaedic surgeon. It is the job of an orthopaedic surgeon to "connect the bone", but if a facial fracture occurs, they actually have to go to a dental hospital for treatment by a maxillofacial surgeon.
"This is because the fractures of the maxillofacial region are very different from those of other parts such as limbs." Li Huaiqi, deputy chief physician of the Department of Oral and Maxillofacial Surgery, Jiangsu Provincial Stomatological Hospital, told the Yangzi Evening News/Ziniu News reporter that the roots of our teeth are deeply buried in the jaw. Inside the bone is a very important chewing organ.
The bones in other parts of the human body are broken or displaced, and most of them can be restored to their original shape. However, for maxillofacial fractures, not only the reduction of the fracture, but also the aesthetic needs of the head and face, but also the teeth in the mouth should be considered. Problems such as occlusion, emphasizing the recovery of function, each item is very important, so it is not a simple orthopaedic doctor to deal with.
Oral and maxillofacial surgery can sometimes be life-saving problems.
"We once treated a female patient. When the truck rolled over, the patient's face also slid out of the highway. The huge external force caused the entire soft tissue of half of the face to be torn off and the bones were fractured. , the flesh on half of the face is gone." Li Huaiqi said that the blood supply to the face is rich, and the patient first faces the rescue of heavy bleeding, and then deals with the damage to the face.
If the bone is broken, it is fixed with a titanium plate; if the facial muscles are deficient, an adjacent skin flap is designed from the hidden part of the neck to cover the wound; the facial nerve is also torn and the defect is too large to be reconnected, so other non-important The nerves are taken from the site, and the nerves at both ends are connected like a bridge and a road.
The patient's surgical inpatient repair has gone through more than 10 days, and the later rehabilitation training and neurological recovery will also take longer.
In general, the patient who lost half of his face recovered well after repair.
About 3D printing:
It is very common to use "templates", so that doctors can no longer repair by "feeling"
Li Huaiqi told reporters that 3D printing is an industry that has developed rapidly in the medical field for more than ten years. It is the product of the development of biological tissue engineering, materials science, computer imaging and other technologies.
"For example, if one side of the patient's face is damaged, the traditional repair is that the doctor's 'feeling', based on his own experience, compares the appearance of the other side to complete the repair. But with computer digital technology, we The patient's photos, CT or MRI data can be imported into the system, and the computer will complete the reconstruction." Chief Physician Li Huaiqi said that after reconstruction, the 3D printing technology can use titanium metal or other polymer materials to print normal In terms of bone morphology, patients can intuitively see the restorative effect, and doctors also have templates for restoration.
Using 3D printing technology to make templates and repairing on this basis has been widely used in clinical practice.
Especially in oral and maxillofacial surgery, because the facial bones are curved and require high precision, it is also very suitable for 3D printing technology.
Deputy Chief Physician Li Huaiqi gave an example. A young man had a tumor on his mandible. Although the tumor was benign, it was huge.
"The mandible can't bear such damage, which means that the tumor eventually 'eats' the bone, and the entire mandible is broken. If only one titanium alloy plate is punched, it will have a great impact on the function. In the end, our plan is to take the leg. The fibula of the lower part is used for repair." Li Huaiqi explained that the mandible is curved and the leg bone is "straight and straight", so it cannot be used directly.
That's when 3D printing technology was used.
After the digital reconstruction, the doctor preformed the titanium alloy plate according to the normal shape of the printed mandible, which fits perfectly.
With the template, the doctor shapes the leg bone according to the shape of the mandible, splices it together, and finally completes the entire reconstruction and repair process.
There are already successful cases in Jiangsu for printing out bones and implanting them in the human body
According to media reports, Lin Zhiying's facial reconstruction plan may be that a larger part of the face will be implanted with titanium alloys, and another part of the finer bones will be reconstructed through 3D printing technology. After the reconstructed bones are in contact with the body, bone cells can be The attachment grows in, merging the implant with the bone.
Printing out bones that can be implanted into the human body sounds very technological.
Li Huaiqi told the Yangzi Evening News/Ziniu News reporter that 3D printing implantable "bones and flesh" has actually been explored clinically.
Around 2015, Shanghai 411 All-Military Oral Center 3D printed a piece of mandible implanted into the human body, which was the first 3D printed mandible implantation operation in the country; in 2019, the Stomatological Hospital of Air Force Military Medical University used 3D printed polyetheretherketone material to reconstruct The "chin" joint is the world's first 3D printed mandibular joint implant.
The Jiangsu Provincial Stomatological Hospital also completed 3 cases of 3D printed mandibular implantation around 2020, and all 3 cases were successful.
"But there is still a long way to go to 3D print bones for direct implantation into the human body. Printing soft tissues such as 'flesh' is even more difficult." Li Huaiqi said that the country has very strict requirements for medical implantation. Human body materials also need to pass various tests such as biosafety.
What material is used to print, the repaired parts are different, and the materials are also different.
3D printing is personalized customization, and there is no way to produce it on a large scale. Therefore, there is no ready-made, very clear standard to measure the product. Every implantation case must undergo strict ethical review.
At present, 3D printing is directly implanted into the "bones" of the human body, and the price is also very expensive. The "volume" of the mandible may cost hundreds of thousands of yuan per pair. These are the objective reasons that this technology cannot be widely used. limit.
"In addition, from a biological point of view, after thousands of years of evolution, bones are very precise. They not only have good strength, but also can withstand the forces transmitted by teeth chewing. They can also attach to muscles, nerves and blood vessels to control movement to complete functions. The 3D printed materials are currently incomparable with the native bones." Li Huaiqi told reporters that it is still difficult for the neuromuscular to attach to the printed materials, and it is almost impossible to repair teeth on these materials, and it is also the most important. On the other hand, the material does not meet the requirements of biomechanics, and it is prone to postoperative infection and exposure. These are all problems that need to be overcome.
Extended question: Can Lin Zhiying's "ageless face" be restored?
Many people are concerned that Lin Zhiying's "ageless face" can be restored through 3D reconstruction technology?
Some people have also thought about it. If the face is 3D reconstructed, can the doctor "smoothly" the whole face, raise the nose and fill in some fat, can it also make the face more "optimized"?
Li Huaiqi said that many facial fractures are caused by trauma, which does affect the appearance, but oral and maxillofacial surgeons are more concerned about the medical treatment itself.
If the patient's injury is complicated, or even accompanied by a large range of defects, it must be advocated for medical treatment first to repair the outline.
After 3-6 months, the condition is relatively stable, and the local recovery is relatively good, and then individualized aesthetic adjustments are carried out, and "remedial" measures such as scar removal and filling of depressions are carried out.
Restorative surgery and curative surgery cannot be done at the same time. It requires good communication and cooperation between the patient and the doctor to restore the face to the greatest extent.