The use of virtual surgery, patient-specific saw and drill guides, and custom-made osteosynthesis plates is rapidly spreading from deformity surgery to orthognathic surgery. Most of the commercially available systems are using computer-aided design/computer-aided manufacture (CAD/CAM) wafers to produce patient-specific saw guides. However, most plate systems provided are still the conventional "in stock" mini plates that can be individually designed by pre-bending according to the stereolithographic model of the patient. Custom made three-dimensional (3D) printed implants have earlier been demonstrated to be an ideal solution in deformity surgery and in reconstruction of complex posttraumatic cases. In this study, we report the novel use of patient-specific saw and drill guides combined with patient-specific 3D titanium alloy implants as a fixation system in maxillary movement after Le Fort I and bimaxillary osteotomies (n = 32). The implants were individually designed for each patient to follow anatomical structures and to provide exact positioning and stability of the repositioned maxilla.

Matrix metalloproteinases (MMP-2 and MMP-9, or gelatinases) are involved in tongue SCC invasion, metastasis and angiogenesis. We have recently shown that a novel and selective hydrophobic cyclic CTTHWGFTLC (CTT1) peptide is inhibitor for MMP-2 and MMP-9 (Koivunen et al., Nat Biotechnol 1999; 17:768-74). In this study, we demonstrate that both the new hydrophilic derivate GRENYHGCTTHWGFTLC (CTT2) peptide and the CTT1 peptide inhibited specifically the human tongue squamous cell carcinoma (HSC-3) cell-derived gelatinolytic activity and in vitro invasion and migration of these cells (p 0.049). In situ zymography revealed that both peptides also inhibited clearly almost all of the gelatinolytic activity present in the human tongue SCC tissue sections, indicating that MMP-2 and MMP-9 are the major gelatinases detected in the tongue carcinomas. However, CTT2 did not inhibit the type I collagen degradation by human collagenases (MMP-1, MMP-8 and MMP-13). Furthermore, CTT2 reduced the blood vessel density (p 0.043) and clearly improved the survival of the mice bearing human tongue carcinoma xenografts (p 0.012). Overall, we suggest that CTT1 and CTT2 peptides being selective gelatinase inhibitors with significant anti-tumor properties could be useful to diminish the invasion and angiogenesis of human tongue carcinomas characterized by enhanced gelatinolytic activity in tumors. ' 2005 Wiley-Liss, Inc.Key words: tongue carcinoma; matrix metalloproteinase; small peptide inhibitors; invasion Worldwide, oral and pharynx cancer is the eighth most common solid tumor, representing about 5% of all the malignancies.1 The incidence of oral cancer, especially mobile tongue carcinoma, is increasing, representing over one third of the malignant tumors in the oral cavity. Overall mortality rate has been unchanged over the last decades and over 50% of tongue SCC patients die within 5 years. Especially in advanced tumors, surgery and radiation therapy are often insufficient for the clinical management of tongue cancer patients, and metastases are frequently the cause for the death. 2-4