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Multicenter study on the use of patient-specific CAD/CAM reconstruction plates for mandibular reconstruction
- Source :
- International Journal of Computer Assisted Radiology and Surgery. 10:2035-2051
- Publication Year :
- 2015
- Publisher :
- Springer Science and Business Media LLC, 2015.
-
Abstract
- For the new generation of mandibular reconstruction, patient-specific mandible reconstruction plates (PSMPs) have been developed which are milled from titanium after preoperative computer planning using CAD/CAM procedures. Resection margins and plate position are determined by surgical guides. In addition, length and shape of the plate and the number and angulation of the screw holes can be planned. 30 patients received such PSMP. Indication ranged from stabilization osteosynthesis, single alloplastic stand-alone reconstruction to microvascular reconstructions. Time for planning, fit of surgical guides and plates, pre-/postoperative occlusion, radiological position of the temporo mandibular joint and complications were recorded. The median time for online planning was 35 min. The results concerning fit and handling of the PSMP and the surgical guides were mainly very positive. In six cases, the plan had to be adapted to the intraoperative clinical needs. The postoperative position of the condyles in the temporo mandibular fossae was regular in 28 cases. The evaluation of the occlusion was not representative due to not clearly identifiable occlusion in 2/3 of the cases. Nevertheless, complications like postoperative extraoral plate exposure, infection, graft and flap necrosis or difficulties to position the guides or the plate during surgery occurred. Mandibular reconstruction with PSMP offers a broad range of opportunities and benefits compared with standard procedures and can be recommended for all kind of mandibular reconstructions. It is not yet foreseeable whether PSMP will in future become routine clinical practice for mandibular reconstruction or will be confined to selected isolated cases.
- Subjects :
- Adult
Male
medicine.medical_treatment
Biomedical Engineering
Dentistry
Health Informatics
CAD
Prosthesis Design
Surgical Flaps
Condyle
Occlusion
Humans
Medicine
Radiology, Nuclear Medicine and imaging
Fibula
Aged
Aged, 80 and over
Titanium
Computer-assisted surgery
Osteosynthesis
business.industry
Mandible
General Medicine
Middle Aged
Computer Graphics and Computer-Aided Design
Computer Science Applications
Surgery, Computer-Assisted
Radiological weapon
Computer-Aided Design
Female
Surgery
Computer Vision and Pattern Recognition
Mandibular Reconstruction
business
Bone Plates
Jaw Diseases
Subjects
Details
- ISSN :
- 18616429 and 18616410
- Volume :
- 10
- Database :
- OpenAIRE
- Journal :
- International Journal of Computer Assisted Radiology and Surgery
- Accession number :
- edsair.doi.dedup.....3c9634a30104998259edb2af699c3547