The objective of this retrospective study is to verify the effectiveness and safety of patient-specific titanium implants on maxillofacial bones, with a long-term follow-up. Total 16 patients with various maxillofacial defects underwent reconstruction using patient-specific titanium implants. Titanium implants, manufactured by electron beam melting, selective laser sintering, or milling, were inserted into the maxilla, mandible, or zygoma. Long-term follow‐up (36.7 ± 20.1 months) was conducted after the surgery. Bone fusion of the titanium implant body, postoperative infection, implant malunion, functional results, patient satisfaction, subsidence, osteolysis around the implants, and complications were recorded and analyzed at the last follow-up. Of the 28 implants, only one failed to unite with the bone; therefore, revision surgery was performed. No osteolysis or subsidence around the titanium implants nor adverse events were observed; the mean VAS score for satisfaction was 9. All patients enrolled in this trial were esthetically and functionally satisfied with their surgical results, and fixation failure and esthetic dissatisfaction complications were well resolved. Patient-specific titanium showed satisfactory outcomes when used to treat various oral and maxillofacial defects. A 3D printed titanium implant can be effectively used in the reconstruction of the zygoma and mandible instead of autogenous bone without donor site morbidity.
The purpose of this study was to evaluate the clinical efficacy and safety of patient-specific additive-manufactured CaOSiO2-P2O5-B2O3 glass-ceramic (BGS-7) implants for reconstructing zygomatic bone defects at a 6-month follow-up. A prospective, single-arm, single-center, clinical trial was performed on patients with obvious zygoma defects who needed and wanted reconstruction. The primary outcome variable was a bone fusion between the implant and the bone evaluated by computed tomography (CT) at 6 months post surgery. Secondary outcomes, including implant immobilization, satisfaction assessment, osteolysis, subsidence of the BGS-7 implant, and safety, were assessed. A total of eight patients were enrolled in the study. Two patients underwent simultaneous reconstruction of the left and right malar defects using a BGS-7 3D printed implant. Cone beam CT analysis showed that bone fusion at 6 months after surgery was 100%. We observed that the average fusion rate was 76.97%. Osteolysis around 3D printed BGS-7 implants was not observed. The mean distance displacement of all 10 implants was 0.4149 mm. Our study showed no adverse event in any of the cases. The visual analog scale score for satisfaction was 9. All patients who enrolled in this trial were aesthetically and functionally satisfied with the surgical results. In conclusion, this study demonstrates the safety and promising value of patient-specific 3D printed BGS-7 implants as a novel facial bone reconstruction method.
BackgroundTwo-jaw surgery including mandibular and maxillary backward movement procedures are commonly performed to correct class III malocclusion. Bimaxillary surgery can reposition the maxillofacial bone together with soft tissue, such as the soft palate and the tongue base. We analyzed changes of pharyngeal airway narrowing to ascertain clinical correlations with the prevalence of snoring after two-jaw surgery.MethodsA prospective clinical study was designed including a survey on snoring and three-dimensional (3D) computed tomography (CT) in class III malocclusion subjects before and after bimaxillary surgery. We conducted an analysis on changes of the posterior pharyngeal space find out clinical correlations with the prevalence of snoring.ResultsAmong 67 subjects, 12 subjects complained about snoring 5 weeks after the surgical correction, and examining the 12 subjects after 6 months, 6 patients complained about the snoring. The current findings demonstrated the attenuation of the largest transverse width (LTW), anteroposterior length (APL), and cross-sectional area (CSA) following bimaxillary surgery given to class III malocclusion patients, particularly at the retropalatal level. The average distance of maxillary posterior movements were measured to be relatively higher (horizontal distance 3.9 mm, vertical distance 2.6 mm) in case of new snorers.ConclusionsThis study found that bimaxillary surgery could lead to the narrowing of upper airway at the retropalatal or retroglossal level as well as triggering snoring in subjects with class III malocclusion. Based on the current clinical findings, we also found that upper airway narrowing at retropalatal level may contribute to increasing the probability of snoring and that polysonography may need to be performed before orthognathic surgery in subjects with class III malocclusion.
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