Bone Reconstruction Planning Using Computer Technology for Surgical Management of Severe Maxillomandibular Atrophy

Wong, Mark; Kau, Chung How; Melville, James C.; Patel, Tirth; Spagnoli, Daniel B.

doi:10.1016/j.coms.2019.03.008

Cited by 19 publications

(13 citation statements)

References 12 publications

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“…This was only made possible because of a clear understanding of the end goals of treatment and the careful use of 3D virtual planning. These methods have been showed to help create the best possible outcomes to aid both the orthodontist and surgeon (Wang et al, 2019; Wong et al, 2019). In addition, it also created the most ideal aesthetic results (Kyteas et al, 2017).…”

Section: Summary and Discussionmentioning

confidence: 99%

Team approach in the management of revision surgery to correct bilateral temporomandibular joint replacements

2020

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This case report describes the successful second surgical treatment of a 26-year-old white female patient with a retrognathic mandible and previous bilateral total joint prostheses placement. The patient had previously presented with bilateral idiopathic condylar resorption (ICR) which caused clockwise mandibular rotation and resulted in anterior open bite and a retrognathic mandible. The patient had undergone definitive corrective for the ICR where condylectomies were performed bilaterally. In addition, total joint prostheses using ‘stock joints’ were used to restore the condyle and glenoid fossa on both sides. Although the previous surgery corrected the anterior open bite and restored the condyles, the patient was still suffering from joint symptoms (significant pain), restricted mandibular movements, increased overjet (12 mm) and a retrognathic mandible. The treatment plan included a combined orthodontic surgical approach: (1) bimaxillary orthognathic surgery: a surgical procedure on the mandible to reposition the prosthetic joints and correct the mandible position, and a segmental LeFort I to expand the maxilla; and (2) post-surgical orthodontics treatment to detail the occlusion. At the end of the treatment, good aesthetic and functional results were obtained with the cooperation of two specialties. This case emphasises the importance of three-dimensional planning and multidisciplinary treatment when addressing complex jaw movements. It also emphasises the importance orthodontic planning and collaboration with the orthodontist.

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Section: Summary and Discussionmentioning

confidence: 99%

Team approach in the management of revision surgery to correct bilateral temporomandibular joint replacements

2020

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“…Both panoramic radiographs and CBCT were used in the earlier studies to assess tooth root length [ 20 , 21 , 26 , 30 ]. Currently, CBCT has been widely used in orthodontic treatment as an important tool for determining impacted tooth location [ 32 ], facial asymmetry [ 33 ], supernumerary teeth, temporomandibular joint (TMJ) pathology [ 34 ], airway construction, as well as for surgical planning [ 35 , 36 ]. Previous study has shown that the tooth length and root length measured by CBCT has no significant difference from the actual tooth length, indicating that CBCT scan provides enough accuracy for tooth crown and root length measurement [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

A randomized trial on the effects of root resorption after orthodontic treatment using pulsating force

et al. 2020

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Background An orthodontic device that moves teeth with pulsating force was invented and underwent a single center, controlled, clinical trial to test its safety and efficacy for treatment. The device has a custom-made thermo-plastic mouthpiece which fits over the teeth with an inflatable silicone element. A console that measures and controls the pulsating force level in real-time controls the air pressure that delivers a pulsating force. In this study, the effect of the device on root resorption during orthodontic treatment was evaluated using 3D cone beam computed tomography and compared with a control group of patients who received Invisalign treatment. Methods Twenty-eight subjects were enrolled in the investigational arm and 15 in the control group. Subjects were followed until the average score of the mandibular and maxillary teeth achieved a Little’s Irregularity Index of 1.5 mm or less. Results There were no adverse events reported throughout the study for either treatment arm. No clinically significant root resorption was observed for either group. The investigational device did not cause root resorption greater than the control group. Both devices produced a safety profile compared to current orthodontic techniques. Conclusion The investigational device did not produce more root resorption than similar conventional orthodontic appliances. Trial registration ClinicalTrials.gov, NCT03421886 . Registered 12 January 2018 - Retrospectively registered.

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“…The complex 3D structures of the face and head require a lot of experience and skill on the part of the surgeon. Without computer-assisted planning and navigation, therapy is only possible with difficulty ( 3 – 5 ). Tumor resection is often associated with the loss of essential, functional structures of the face ( 6 ).…”

Section: Introductionmentioning

confidence: 99%

Advances in the Resection and Reconstruction of Midfacial Tumors Through Computer Assisted Surgery

2021

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Curatively intended oncologic surgery is based on a residual-free tumor excision. Since decades, the surgeon’s goal of R0-resection has led to radical resections in the anatomical region of the midface because of the three-dimensionally complex anatomy where aesthetically and functionally crucial structures are in close relation. In some cases, this implied aggressive overtreatment with loss of the eye globe. In contrast, undertreatment followed by repeated re-resections can also not be an option. Therefore, the evaluation of the true three-dimensional tumor extent and the intraoperative availability of this information seem critical for a precise, yet substance-sparing tumor removal. Computer assisted surgery (CAS) can provide the framework in this context. The present study evaluated the beneficial use of CAS in the treatment of midfacial tumors with special regard to tumor resection and reconstruction. Therefore, 60 patients diagnosed with a malignancy of the upper jaw has been treated, 31 with the use of CAS and 29 conventionally. Comparison of the two groups showed a higher rate of residual-free resections in cases of CAS application. Furthermore, we demonstrate the use of navigated specimen taking called tumor mapping. This procedure enables the transparent, yet precise documentation of three-dimensional tumor borders which paves the way to a more feasible interdisciplinary exchange leading e.g. to a much more focused radiation therapy. Moreover, we evaluated the possibilities of primary midface reconstructions seizing CAS, especially in cases of infiltrated orbital floors. These cases needed reduction of intra-orbital volume due to the tissue loss after resection which could be precisely achieved by CAS. These benefits of CAS in midface reconstruction found expression in positive changes in quality of life. The present work was able to demonstrate that the area of oncological surgery of the midface is a prime example of interface optimization based on the sensible use of computer assistance. The fact that the system makes the patient transparent for the surgeon and the procedure controllable facilitates a more precise and safer treatment oriented to a better outcome.

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Bone Reconstruction Planning Using Computer Technology for Surgical Management of Severe Maxillomandibular Atrophy

Cited by 19 publications

References 12 publications

Team approach in the management of revision surgery to correct bilateral temporomandibular joint replacements

Team approach in the management of revision surgery to correct bilateral temporomandibular joint replacements

A randomized trial on the effects of root resorption after orthodontic treatment using pulsating force

Advances in the Resection and Reconstruction of Midfacial Tumors Through Computer Assisted Surgery

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