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Individual prostheses and resection templates for mandibular resection and reconstruction
H Eufinger1, M Wehmöller, E Machtens
1Department of Oral and Maxillofacial Surgery--Regional Plastic Surgery at the University Hospital Knappschafts-Krankenhaus, Ruhr-University, Bochum, Germany.
The British Journal of Oral & Maxillofacial Surgery
|March 5, 1998
Summary
This study introduces a precise technique for fabricating custom mandibular prostheses using 3D imaging and CAD/CAM. While technically successful, the long-term clinical outcomes for patients were ultimately poor.
Area of Science:
- Oral and Maxillofacial Surgery
- Biomedical Engineering
- Medical Imaging
Background:
- Mandibular defects require precise reconstruction for optimal function and aesthetics.
- Traditional methods can be time-consuming and may lack accuracy.
- Advancements in imaging and manufacturing offer potential for improved surgical outcomes.
Observation:
- A novel technique utilizing helical computed tomography (CT) data and computer-aided design/manufacturing (CAD/CAM) was developed.
- This method enables the preoperative fabrication of patient-specific mandibular prostheses and resection templates.
- Titanium fixation plates were integrated with the prostheses, with identical data used for resection template creation.
Findings:
- The technique demonstrated high precision, safety, and speed in four patient cases, leading to excellent aesthetic and functional results.
- Resection templates accurately guided oscillating saws for precise bone resection, matching prosthesis margins.
- Prostheses were securely stabilized using the same screw holes utilized by the templates.
Implications:
- This CAD/CAM-driven approach offers a highly accurate method for mandibular reconstruction.
- Successful soft-tissue coverage is crucial for the long-term success of these large prostheses.
- Despite superior technical aspects, the clinical long-term results of this technique were poor, warranting further investigation.