不同灭菌方式对颌面外科3D打印导板灭菌效果及其理化性能的影响

Effects of different sterilization methods on 3D-printed guide plates for maxillofacial surgery and physical and chemical properties

  • 摘要: 目的 旨在对比3种灭菌方式对颌面外科3D打印导板灭菌效果、材料强度和尺寸精度的影响。方法 随机抽取某口腔专科医院颌面外科手术中以MED 610材料制作的3D打印导板实物50件,并用同种材料和方式制备3D打印导板标准件20件。按照灭菌方式随机分为A-A2组、B-B2组、C-C2组和D-D1组,其中A-A2组采用戊二醛浸泡灭菌、B-B2组采用压力蒸汽灭菌、C-C2组采用过氧化氢低温等离子体灭菌、D-D1组为空白对照组。比较不同灭菌方式下3D打印导板的灭菌合格率、尺寸精度和材料强度。结果 B1组和C1组对白色念珠菌的灭菌合格率均为100.00%,A1组的灭菌合格率为60.00%; A组、B组、C组评价灭菌尺寸精度变化的指标的均方根值(RMS)均值分别为 0.03、0.06、0.04 mm,尺寸精度变化均在临床可接受范围(<0.2 mm); 过氧化氢低温等离子体灭菌对MED610材料3D 打印导板力学性能的影响更为显著(Z=1.984,P=0.047); 在成本效益方面,压力蒸汽灭菌展现出最优的综合性能。结论 对于颌面外科以MED 610材料通过PolyJet 3D 打印技术制备的3D打印导板,121 ℃压力蒸汽灭菌方式兼具灭菌可靠性和材料稳定的优势,更契合临床实际需求,可作优选灭菌方案。

     

    Abstract: OBJECTIVE To compare the effects of three sterilization methods on the sterilization efficacy, material strength and dimensional accuracy of 3D-printed guide plates used in maxillofacial surgery. METHODS Totally 50 actual 3D-printed guide plates that were made of MED 610 material and used for maxillofacial surgeries were randomly chosen from a specialized stomatological hospital. Additionally, 20 standard 3D-printed guide plates were made with the use of same material and method. The guide plates were randomly divided into the A-A2, B-B2, C-C2, and D-D1 groups based on sterilization methods. The group A-A2 was treated glutaraldehyde immersion sterilization, the group B-B2 was treated with pressure steam sterilization, the group C-C2 was treated with hydrogen peroxide low-temperature plasma sterilization, and the group D-D1 was taken as the blank control. The qualified rate of sterilization, dimensional accuracy and material strength of the 3D-printed guide plates were observed and compared among the different sterilization modes. RESULTS The qualified rate of sterilization of Candida albicans was 100.00% in the group B1 and the group C1, 60.00% in the group A1. The average value of root-mean-square(RMS) for evaluation of the change of dimensional accuracy was 0.03 mm in the group A, 0.06 mm in the group B, 0.04 mm in the group C, with all the variation of dimensional change in acceptable range for clinical practice(<0.2 mm). The hydrogen peroxide low-temperature plasma sterilization showed more remarkable effect on mechanical property of the 3D-printed guide plates made of MED610(Z=1.984,P=0.047). With the regard to cost effectiveness, the pressure steam sterilization showed the optimal overall performance. CONCLUSION For the maxillofacial surgery, the 3D-printed guide plates that are made of MED 610 material by PolyJet 3D printing technology and are treated with pressure steam sterilization under 121 ℃, which has the advantages of reliable sterilization and stable material, better conform to the actual requirements for clinical practice and can be taken as an optimal sterilization program.

     

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