Immediate Reconstruction of Bilateral Mandible Defects: Management Based on Computer-Aided Design/Computer-Aided Manufacturing Rapid Prototyping Technology in Combination With Vascularized Fibular Osteomyocutaneous Flap

Hou, Jinsong; Mu, Chen; Pan, Chaobin; Tao, Qian; Wang, Jianguang; Wang, Cheng; Zhang, Bin; Huang, Hongzhang

doi:10.1016/j.joms.2010.07.047

Cited by 36 publications

(24 citation statements)

References 28 publications

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“…Another method described by Hou and colleagues is the use of a pre-shaped titanium mesh implant, which surrounds a vascularized fibular osteomyocutaneous flap [18]. …”

Section: Introductionmentioning

confidence: 99%

Evaluation of computer-assisted mandibular reconstruction with vascularized iliac crest bone graft compared to conventional surgery: a randomized prospective clinical trial

Ayoub

Ghassemi

Rana

et al. 2014

Trials

109

101

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BackgroundComputer-assisted surgery plays an increasingly important role in mandibular reconstruction, ensuring the best possible masticatory function and aesthetic outcome.MethodsTwenty patients were randomly assigned to computer-assisted or conventional mandibular reconstruction with vascularized iliac crest bone graft in a prospective study design.Virtual surgical planning was based on preoperative CT-data using specific surgical planning software. A rapid prototyping guide transferred the virtual surgery plan to the operation site. During surgery the transplant ischemic time, reconstruction time, time for shaping the transplant and amount of bone removed were measured. Additionally, the difference in the intercondylar distance before and after surgery was calculated.ResultsComputer-assisted surgery shortened the time of transplant ischemia (P < 0.005) and defect reconstruction (P < 0.001) compared to conventional surgery. The time to saw and shape the transplant at the donor site was shorter using conventional surgery (P < 0.005); therefore, the overall time for surgery didn’t change (P = 0.527). In the computer-assisted group, the amount of bone harvested equaled the defect size, whereas the transplant size in the conventional group exceeded the defect site by 16.8 ± 5.6 mm (P < 0.001) on average. The intercondylar distance before compared to after surgery was less affected in the computer-assisted than in the conventional group (P < 0.001).ConclusionsThe presented study shows that computer-assisted surgery can help reduce the time for mandibular defect reconstruction and consequently the transplant ischemic time. In the computer-assisted group, the iliac crest donor site defect was downsized and the postoperative condyle position was less altered, reducing possible risks of postoperative complications and donor site morbidity.Trial RegistrationDRKS00005181.

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“…Another method described by Hou and colleagues is the use of a pre-shaped titanium mesh implant, which surrounds a vascularized fibular osteomyocutaneous flap [18]. …”

Section: Introductionmentioning

confidence: 99%

Evaluation of computer-assisted mandibular reconstruction with vascularized iliac crest bone graft compared to conventional surgery: a randomized prospective clinical trial

Ayoub

Ghassemi

Rana

et al. 2014

Trials

109

101

View full text Add to dashboard Cite

show abstract

“…This often resulted in a prolonged intraoperative time and suboptimal reconstruction of a region requiring a high degree of precision for optimal orthognathic and esthetic outcome (Hirsch et al, 2009). Today, CAD/CAM technology offers a reduction in the learning curve associated with osseous contouring, enhanced levels of accuracy, acceleration of the time-consuming intraoperative steps, improved esthetic contour, and improved functional outcome (Hou et al, 2011;Lethaus et al, 2011;Hayden et al, 2012;Levine et al, 2012;Foley et al, 2013). Various studies have revealed that application of the CAD/CAM technique eliminates the need for intraoperative measurement and yields bony segments with excellent apposition, achieves faithful duplication of the preoperative plan, and requires only minimal adjustments when the osseous transplant is inset (Marchetti et al, 2006;Hirsch et al, 2009;Antony et al, 2011).…”

Section: Introductionmentioning

confidence: 99%

Costs incurred by applying computer-aided design/computer-aided manufacturing techniques for the reconstruction of maxillofacial defects

Rustemeyer

Melenberg

Sari-Rieger

2014

Journal of Cranio-Maxillofacial Surgery

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“…Regarding mandibular reconstruction, Goto et al [8] reported three cases of surgical simulation for reconstruction of mandibular bone defects using photocurable plastic skull models. Recently, CAD/CAM-assisted 3-D skull models were used for prebending of mandibular reconstruction plates [13] or titanium trays to fix vascularized fibula [14], and for virtual surgical simulation using double-barrel fibular bone [15] to reconstruct the mandible. To our knowledge, the present report is the first description of computer-assisted mandibular reconstruction with a custom-made Ti-mesh tray and PCBM.…”

Section: Discussionmentioning

confidence: 99%

Mandibular reconstruction using custom-made titanium mesh tray and particulate cancellous bone and marrow harvested from bilateral posterior ilia

Yamada¹,

Nakaoka²,

Horiuchi³

et al. 2013

Journal of Plastic Surgery and Hand Surgery

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The objective of this study is to evaluate usefulness of mandibular reconstructions using a custom-made titanium mesh (Ti-mesh) tray and particulate cancellous bone and marrow (PCBM). A consecutive nine patients who underwent mandibular reconstruction were enrolled in this study. They were five men and four women (mean age: 53.9 years). Virtual reality simulation was performed using computer software based on the pre-operative computed tomography data. A 3-dimensional (3-D) skull model was constructed using a 3-D printer. A tray was custom-made from a Ti-mesh sheet bent to adapt to the model. After PCBM harvesting from bilateral posterior ilia, the tray was fixed to the host bone. New bone formation and configuration of the reconstructed mandible were assessed radiologically. Complications were recorded in each patient during the follow-up period. Patients, satisfaction with post-operative facial contour was evaluated using a visual analogue scale (VAS score, range = 0-100). In six of nine patients, excellent new bone formation was recognised and expected results were radiologically achieved. Complications occurred in four patients. These complications included Ti-mesh fracture, Ti-mesh exposure in the oral cavity, and delayed infection. Mean VAS score on patient satisfaction was 77.6. Although the data are preliminary, the results suggest that this method is clinically useful.

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Immediate Reconstruction of Bilateral Mandible Defects: Management Based on Computer-Aided Design/Computer-Aided Manufacturing Rapid Prototyping Technology in Combination With Vascularized Fibular Osteomyocutaneous Flap

Cited by 36 publications

References 28 publications

Evaluation of computer-assisted mandibular reconstruction with vascularized iliac crest bone graft compared to conventional surgery: a randomized prospective clinical trial

Evaluation of computer-assisted mandibular reconstruction with vascularized iliac crest bone graft compared to conventional surgery: a randomized prospective clinical trial

Costs incurred by applying computer-aided design/computer-aided manufacturing techniques for the reconstruction of maxillofacial defects

Mandibular reconstruction using custom-made titanium mesh tray and particulate cancellous bone and marrow harvested from bilateral posterior ilia

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