The results of this study suggest that implant survival is high and implant-supported prostheses are a reliable rehabilitation option in patients whose jaws have been reconstruction with a FFF.
Abstract-Computer-assisted surgical (CAS) planning tools are available for craniofacial surgery but are usually based on computer-aided design (CAD) tools that lack the ability to detect the collision of virtual objects (i.e., fractured bone segments). We developed a CAS system featuring a sense of touch (haptic) that enables surgeons to physically interact with individual, patient-specific anatomy and immerse in a threedimensional virtual environment. In this study, we evaluated initial user experience with our novel system compared to an existing CAD system. Ten surgery resident trainees received a brief verbal introduction to both the haptic and CAD systems. Users simulated mandibular fracture reduction in three clinical cases within a 15 min time limit for each system and completed a questionnaire to assess their subjective experience. We compared standard landmarks and linear and angular measurements between the simulated results and the actual surgical outcome and found that haptic simulation results were not significantly different from actual postoperative outcomes. In contrast, CAD results significantly differed from both the haptic simulation and actual postoperative results. In addition to enabling a more accurate fracture repair, the haptic system provided a better user experience than the CAD system in terms of intuitiveness and self-reported quality of repair.
The ideal surgical solution to reconstruct the temporomandibular joint (TMJ) disc after it has been removed has remained elusive. The major obstacle has been identifying a durable biocompatible material that will provide for restoration of TMJ function. The present study evaluated the outcomes of the interpositional implantation of a cryopreserved viable osteochondral allograft (CVOCA) combined with a viable cryopreserved umbilical cord tissue (vCUT) allograft after TMJ discectomy in patients with internal derangement and/or degenerative joint disease (DJD). Patients and Methods: We implemented a retrospective case series study and enrolled patients with DJD or disc displacement diagnosed using the Diagnostic Criteria of Temporomandibular Disorders, who had undergone interpositional CVOCA and vCUT implantation after TMJ discectomy. The primary outcome variable was pain, measured using a visual analog scale (VAS). The secondary outcomes variables included maximal incisal opening (MIO) and Glasgow Benefit Inventory (GBI) general subscale scores. The primary analysis compared the preoperative measures with those at the last follow-up visit. Descriptive and analytic statistics were computed to summarize the sample's characteristics and assess the pre-and postoperative differences. Results: The study sample included 9 patients with a mean age of 36 years, and 44% were men. The VAS scores had decreased significantly from 9.0 AE 2.0 to 3.0 AE 3.0 postoperatively (P = .001). The MIO had increased from 31 AE 5 to 36 AE 5 mm (P = .178). The average GBI general subscale score of 13 AE 46 for the 9 patients showed a trend toward improved quality of life and patient satisfaction with the surgery. The median postoperative follow-up at the time of our report was 15 months (interquartile range, 10; range, 2 to 27) without treatment-related complications.
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