Comparison of intraoperative time measurements between osseous reconstructions with free fibula flaps applying computer-aided designed/computer-aided manufactured and conventional techniques

Rustemeyer, Jan; Sari-Rieger, Aynur; Melenberg, Alex; Busch, Alexander

doi:10.1007/s10006-015-0493-6

Cited by 20 publications

(16 citation statements)

References 27 publications

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“…This approach was also followed by Rustemeyer et al in their investigation of intraoperative times in osseous reconstructions with free fibular grafts. No significant differences were found between the CAD/ CAM group and the conventional implant group (42). This was also shown by Ritschl et al (43) who also revealed no significant differences between these groups (43).…”

Section: Discussionsupporting

confidence: 72%

Comparison of the Accuracy and Clinical Parameters of Patient-Specific and Conventionally Bended Plates for Mandibular Reconstruction

et al. 2021

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ObjectivesThis retrospective study compared two mandibular reconstruction procedures—conventional reconstruction plates (CR) and patient-specific implants (PSI)—and evaluated their accuracy of reconstruction and clinical outcome.MethodsOverall, 94 patients had undergone mandibular reconstruction with CR (n = 48) and PSI (n = 46). Six detectable and replicable anatomical reference points, identified via computer tomography, were used for defining the mandibular dimensions. The accuracy of reconstruction was assessed using pre- and postoperative differences.ResultsIn the CR group, the largest difference was at the lateral point of the condyle mandibulae (D2) -1.56 mm (SD = 3.8). In the PSI group, the largest difference between preoperative and postoperative measurement was shown at the processus coronoid (D5) with +1.86 mm (SD = 6.0). Significant differences within the groups in pre- and postoperative measurements were identified at the gonion (D6) [t(56) = -2.217; p = .031 <.05]. In the CR group, the difference was 1.5 (SD = 3.9) and in the PSI group -1.04 (SD = 4.9). CR did not demonstrate a higher risk of plate fractures and post-operative complications compared to PSI.ConclusionFor reconstructing mandibular defects, CR and PSI are eligible. In each case, the advantages and disadvantages of these approaches must be assessed. The functional and esthetic outcome of mandibular reconstruction significantly improves with the experience of the surgeon in conducting microvascular grafts and familiarity with computer-assisted surgery. Interoperator variability can be reduced, and training of younger surgeons involved in planning can be reaching better outcomes in the future.

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Section: Discussionsupporting

confidence: 72%

Comparison of the Accuracy and Clinical Parameters of Patient-Specific and Conventionally Bended Plates for Mandibular Reconstruction

et al. 2021

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“…Using CAD/CAM guides and prebent plates can help to shorten the operation and flap ischemic times. 5–7 However, the total operation and flap ischemic times did not differ from the averages for the same operation. We believe this was because of the extra time needed to shave the fibula and to rebend the plates to deal with the intraoperative change.…”

Section: Discussionmentioning

confidence: 88%

“…1–7 However, there are no standard procedures for dealing with an intraoperative change in defect size, and CAD/CAM guides may not always be applicable as planned.…”

Section: Introductionmentioning

confidence: 99%

Intraoperative Change in Defect Size during Maxillary Reconstruction Using Surgical Guides Created by CAD/CAM

Morita

Numajiri

Nakamura

et al. 2017

Plastic and Reconstructive Surgery - Global Open

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“…As far this workflow solution was just used for fibula graft but could also be applied to other bone grafts like scapula or iliac crest flaps [ 6 , 22 ]. In literature assessment of surgical time regarding CAD/CAM procedures is heterogenic but mostly states time reduction [ 7 , 10 , 23 ]. The percepted reduction of surgical time has not been tested here, but leads to a lower risk of general complications [ 11 – 13 ].…”

Section: Discussionmentioning

confidence: 99%

“…Thus the effect of reduction of surgery time is a result of a transition of manpower into the pre-surgical phase outside of the OR. The saved surgery time is thus only redeployed as already mentioned [ 7 , 23 ]. Overall there is still an economization as only one person is needed for planning instead of a whole OR team.…”

Section: Discussionmentioning

confidence: 99%

Accelerated workflow for primary jaw reconstruction with microvascular fibula graft

2017

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IntroductionMajor facial defects due to cancer or deformities can be reconstructed through microvascular osteocutaneous flaps. Hereby CAD/CAM workflows offer a possibility to optimize reconstruct and reduce surgical time. We present a retrospectiv observational study regarding the developement of an in-house workflow allowing an accelerated CAD/CAM fibula reconstruction without outsourcing.Case descriptionWorkflow includes data acquisition through computertomography of head and legs, segmentation of the data and virtual surgery. The virtual surgery was transferred into surgical guides and prebent osteosynthesis plate. Those were sterilized and used in surgery.EvaluationThe workflow was used in 30 cases. Minimum planning period took 4 days from CT to surgery, average time was 8 days. Planning could be transferred to surgery every time. Intraoperative complications regarding osteotomy, assembly and fixation did not occur.Discussion/ConclusionAn in-house workflow for CAD/CAM fibula reconstruction is feasible within a few days providing an accelerated procedure even in urgent cases.

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Comparison of intraoperative time measurements between osseous reconstructions with free fibula flaps applying computer-aided designed/computer-aided manufactured and conventional techniques

Abstract: Despite the advantages of the CAD/CAM technique, including reduced ischemia time of osteocutaneous fibula flaps, there is no impact on total reconstruction time or flap survival.

Cited by 20 publications

References 27 publications

Comparison of the Accuracy and Clinical Parameters of Patient-Specific and Conventionally Bended Plates for Mandibular Reconstruction

Comparison of the Accuracy and Clinical Parameters of Patient-Specific and Conventionally Bended Plates for Mandibular Reconstruction

Intraoperative Change in Defect Size during Maxillary Reconstruction Using Surgical Guides Created by CAD/CAM

Accelerated workflow for primary jaw reconstruction with microvascular fibula graft

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