BackgroundThis study examined the usefulness of the fibula positioning guide for boosting the accuracy of mandible reconstructions.MethodsThirty mandibular rapid prototype (RP) models were allocated to experimental (N = 15) and control (N = 15) groups. For reference, we prepared a reconstructed mandibular RP model with a three-dimensional printer, based on surgical simulation. In the experimental group, a fibula positioning guide template and fibula cutting guide, based on simulation, were used to reconstruct the mandible with a fibula graft. In the control group, only the fibula cutting guide, with reference to the reconstructed RP mandible model, was used to reconstruct the mandible with a fibula graft. The two mandibular reconstructions were compared to the surgical simulation by registering images with the non-surgical right side of the mandible. On the reconstructed side, 3D measurements were compared between the surgical simulation and actual surgery, and the sum of differences was taken as the total error.ResultsThe combined use of the fibula cutting and positioning guides produced a smaller total error (mean ± SD: 10.0 ± 7.9 mm) than the fibula cutting guide alone (12.8 ± 8.8 mm; p = 0.015). The greatest point error was the vertical error at the mesial point of the anterior fibula segment. The anteroposterior and lateral errors were not significantly different between groups. These results showed that these two methods were not significantly different, except in the total and vertical errors.ConclusionsConsidering the CAD/CAM processes required for creating positioning devices, the benefit provided with a positioning guide justified its use over the fibula cutting guide alone.
BackgroundThe present study introduces the design and fabrication of a simple surgical guide with which to perform genioplasty.MethodsA three-dimensional reconstruction of the patient’s cranio-maxilla region was built, with a dentofacial skeletal model, then derived from CT DICOM data. A surgical simulation was performed on the maxilla and mandible, using three-dimensional cephalometry. We then simulated a full genioplasty, in silico, using the three-dimensional (3D) model of the mandible, according to the final surgical treatment plan. The simulation allowed us to design a surgical guide for genioplasty, which was then computer-rendered and 3D-printed. The manufactured surgical device was ultimately used in an actual genioplasty to guide the osteotomy and to move the cut bone segment to the intended location.ResultsWe successfully performed the osteotomy, as planned during a genioplasty, using the computer-aided design and computer-aided manufacturing (CAD/CAM) surgical guide that we initially designed and tested using simulated surgery.ConclusionsThe surgical guide that we developed proved to be a simple and practical tool with which to assist the surgeon in accurately cutting and removing bone segments, during a genioplasty surgery, as preoperatively planned during 3D surgical simulations.
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