Digital planning workflow for partial maxillectomy using an osteotomy template and immediate rehabilitation of maxillary Brown II defects with prosthesis

Abstract

Background There is increasing evidence of benefits for the rehabilitation of Brown II defects with prosthesis in surgery. However, the current literature is sparse for maxillary tumour resection using osteotomy templates. Objectives To assess the accuracy of maxillectomy using a custom fabricated osteotomy template and to evaluate the prosthesis for surgical accuracy, appearance and functioning (speech, swallowing and occlusal force). Methods Ten patients with Brown II defects caused by tumour resection were treated with precise partial maxillectomy using an osteotomy template. The immediate rehabilitation of the Brown II defect was completed with a prefabricated prosthesis. The post‐operative three‐dimensional images and the pre‐operative virtual images were superimposed, and average deviation and maximum deviation were calculated. Speech intelligibility, swallowing, appearance and University of Washington Quality of Life Questionnaire (UW‐QoL) were examined at 1, 3 and 6 months after surgery. Occlusal force was examined post‐operatively at 6 months. Results The maximum deviation between the actual and virtual surgery was 5.12 ± 0.44 mm, with an average of 1.02 ± 0.17 mm. Speech intelligibility, swallowing and UW‐QoL improved significantly (P < .05) after wearing the prosthesis. The recovery index of the occlusal force on the affected side was 20.19%‐32.28%. The skewed degree of the mouth corner, the difference in the height of the left and right lips, the maximum deviation distance and the change area volume decreased significantly (P < .05). Conclusion The precise rehabilitation of maxillary Brown II defects can be achieved using a prosthesis fabricated with an osteotomy template. The prosthesis restored appearance and functional capabilities (such as speech and occlusal force).

Digital workflow feasibility for the fabrication of intraoral maxillofacial prosthetics after surgical resection: a systematic literature review

“…All 33 included articles [2,3,4,5, described the digital workflow for 192 patients, of which 23 were case reports and 10 were case series. The geographic distribution of patient work done had eight from People's Republic of China [2,3,5,23,26,29,45,48], five from the United States of America [31,32,38,42,44], four each from the Republic of Korea [39,40,43,46] and Greece [27,30,33,37], three from the Netherlands [35,49,51], two each from Germany [25,50], Canada [36,47], and Turkey [24,34], and one each from Japan [41], Malaysia [4], and Italy [28].…”

“…For the maxillary prostheses' workflow, data acquisition was done after surgery in all of the cases; the IOS alone was used most frequently [23,25,28,33,39,40,42] followed by CT alone [3,5,30,[36][37][38], CBCT alone [4,29,32], CT with an intraoral scanner [2,26], CBCT with an intraoral scanner [24,27,34], and CT with MRI [35]. Trios 3 was the most common IOS used in 11 studies [2, 23-28, 33, 34, 39, 40].…”

Digital Workflow in Maxillofacial Prosthodontics—An Update on Defect Data Acquisition, Editing and Design Using Open-Source and Commercial Available Software

“…The data available from the existing literature revealed the following acquisition modalities: CT scans [26,29,31,36,39,41,43,46,54,60,67,71], MRIs, CBCTs (for maxillary obturators) [22,24], structured light scanners [19][20][21]23,58], laser scanners [37,49,51,56,57,[62][63][64]68,70], light intensity scanners [30], facial scanners, intraoral scanners (IOSs) [3,18,25,27,32,44,53], desktop scanners [34,66], 3D photogrammetry [28,40,52,55,59,69], the monoscopic photogrammetry technique with a mobile phone [15] or two (or more) of the following combined registration modalities: CT and a facial scanner [61], CT an...…”

“…Commercially available software: Mimics (Materialise, Leuven, Belgium) [22,31,42,43,46,54,60], 3-Matic 12.0 (Materialise, Leuven, Belgium) [21,33], CMF Pro Plan (Materialise, Leuven, Belgium) [29], Geomagic Studio (Geomagic, owned by 3D Systems, Rock Hill, SC, USA) [26,47], Free Form Software (SensAble Technologies, owned by 3D Systems, Rock Hill, SC, USA) [36], the ClayTools system (SensAble Technologies, owned by 3D Systems, Rock Hill, SC, USA) [50], 3DDoctor (Able Software Corp, Lexington, KY, USA) [67], Zbrush (Pixlogic Inc.) [39] and Osteo3D (Karnataka, India) [41], (Table 1); • Open-source software: Meshmixer (AutoDesk Inc.) [24].…”

“…Commercially available software: Geomagic Studio (3D Systems, Rock Hill, SC, USA) [20,35,44,47,55,56,60,64,65], Zbrush (Pixlogic Inc.) [28,30,[37][38][39][40], Rapidform (INUS Technology, 3D Systems, Rock Hill, USA) [34,57,62,63,66], Rhinoceros (Robert McNeel & Associates) [51,52,57,62], Free Form (SensAble Technologies, owned by 3D Systems, Rock Hill, USA) [36,45,59,67], Magics (Materialise, Leuven, Belgium) [48,54], 3-Matic (Materialise, Leuven, Belgium) [21,33], Solidworks (Dassault Systèmes) [45] and Cinema 4D R18 (MAXON Computer, GmbH) [19];…”