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Designing CAD/CAM Surgical Guides for Maxillary Reconstruction Using an In-house Approach
Published on: August 24, 2018
An Innovative Approach to Temporomandibular Joint Disorders: The Role of New Generation Surgical Cutting Guides
Adir Cohen1, Shay Sharon1, Heli Rushinek1
1Department of Oral and Maxillofacial Surgery, Hebrew University.
Background:
Additive manufacturing innovations, particularly 3D-printed surgical cutting guides (SCGs), have revolutionized oral and maxillofacial surgery. While SCGs are established for temporomandibular joint (TMJ) replacements, their application in functional TMJ preservation surgeries using transparent photopolymers remains understudied.
Objective:
To assess the efficacy of MED610, a transparent biocompatible photopolymer, in fabricating SCGs for complex TMJ procedures without joint replacement.
Methods:
Four clinical cases were managed using MED610 SCGs: proportional condylectomy for condylar hyperplasia, transoral coronoidectomy for severe trismus, pediatric lateral gap arthroplasty for ankylosis, and eminectomy with pneumatized mastoid air cells. Virtual surgical planning and PolyJet 3D printing enabled guide fabrication, leveraging transparency and thin profiles for precision and minimal invasiveness.
Results:
All cases achieved successful outcomes: Condylectomy restored facial symmetry via accurate bone contouring. Coronoidectomy increased maximal incisal opening from 10 mm to 40 mm. Pediatric arthroplasty preserved medial condylar integrity, achieving 45 mm mouth opening. Eminectomy avoided mastoid cell injury, preventing complications.
Conclusions:
MED610 SCGs enhance surgical accuracy in TMJ preservation surgeries through improved visualization and anatomic adaptation. Their use may reduce reliance on joint replacement in select cases. Broader adoption of this technology could redefine standards in functional TMJ surgery.
