Preservation of Infraorbital Nerve in Orbital Floor and Maxillary Defect Reconstruction With Patient-Specific Three-Dimensional Implant: A Case Report

Cung, Thai-Duong; Hu, Shirley; Govindaraj, Satish; Elahi, Ebby

doi:10.1097/iop.0000000000002180

Cited by 3 publications

(4 citation statements)

References 16 publications

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“…We identified 32 articles reporting data on the use of PEEK PSIs for reconstruction or aesthetic augmentation of the facial skeleton in 194 patients (Table 1, Supplementary Figure S1) (13-23, [25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][41][42][43][44].…”

Section: Resultsmentioning

confidence: 99%

Surface modification of PEEK implants for craniofacial reconstruction and aesthetic augmentation—fiction or reality?

Kauke-Navarro,

Knoedler,

Knoedler

et al. 2024

Front. Surg.

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Facial implantology, a crucial facet of plastic and reconstructive surgery, focuses on optimizing implant materials for facial augmentation and reconstruction. This manuscript explores the use of Polyetheretherketone (PEEK) implants in craniofacial surgery, highlighting the challenges and advancements in this field. While PEEK offers mechanical resilience, durability, and compatibility with imaging modalities, its biologically inert nature hinders integration with the host tissue, which may lead to complications. In this systematic review, our aim was to assess the current state of knowledge regarding the clinical evaluation of Polyetheretherketone (PEEK) implants in facial implantology, with a focus on craniofacial augmentation and reconstruction in human studies. Additionally, we explore and discuss surface and structural modifications that may enhance bioreactivity and reduce complications in PEEK implants. A systematic review identified 32 articles detailing the use of PEEK Patient-Specific Implants (PSIs) in 194 patients for both reconstructive and aesthetic purposes. Complications, including infections and implant failures, were reported in 18% of cases, suggesting the need for improved implant materials. The discussion delves into the limitations of PEEK, prompting the exploration of surface and structural modifications to enhance its bioreactivity. Strategies, such as hydroxyapatite coating, titanium coating, and porous structures show promise in improving osseointegration and reducing complications. However, the literature review did not reveal reports of coated or modified PEEK in facial reconstructive or aesthetic surgery. In conclusion, although PEEK implants have been successfully used in craniofacial reconstruction, their biological inertness poses challenges. Surface modifications, particularly hydroxyapatite coatings, provide opportunities to promote osseointegration. Future research should focus on prospective long-term studies, especially in craniofacial surgery, to investigate the stability of uncoated PEEK implants and the potential benefits of surface modifications in clinical applications. Patient-specific PEEK implants hold promise for achieving durable craniofacial reconstruction and augmentation.

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Section: Resultsmentioning

confidence: 99%

Surface modification of PEEK implants for craniofacial reconstruction and aesthetic augmentation—fiction or reality?

Kauke-Navarro,

Knoedler,

Knoedler

et al. 2024

Front. Surg.

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“…Another fixation method is to fix the implant with screws, which can be further divided into two main types: fixing the implant directly on the inferior orbital floor [ 13 , 29 ] and fixing the implant on the inferior orbital rim [ 4 , 7 , 30 ]. In order to fix the implant directly using screws on the orbital floor, an angled screwdriver is required to fix the screws vertically.…”

Section: Discussionmentioning

confidence: 99%

“…The limitation is that the screw must be driven at an angle rather than at a right angle [ 29 ]. In addition, in the process of drilling the screw, there is a possibility of damage to the blood vessels, nerves, surrounding tissues, and sinus mucosa around the orbital wall [ 13 ]. In addition, since the ethmoid sinus and maxillary sinus wall can be a source of infection, it is important to minimize the damage with minimal manipulation of the sinus [ 31 ].…”

Section: Discussionmentioning

confidence: 99%

“…In addition, it is important to minimize surgical trauma to the eyeball and surrounding tissues, especially to the neurovascular bundle during the surgical procedure. In particular, damage to the blood vessels that penetrate through the bones can cause bleeding [ 13 , 14 ]. Excessive pressure to the eyeball during surgery can result in various side effects, such as oculocardiac reflex [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

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Tongue-in-Groove: A Novel Implant Design for a Blow-Out Fracture

Byeon,

Hwang,

Choi

et al. 2024

JCM

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Background: During blow-out fracture surgery, restoration of the orbital volume and rigid implant fixation are essential. The migration of an implant is a concern of most surgeons. The purpose of this study was to introduce a simple idea of molding and fixing an orbital implant. Methods: In the tongue-in-groove method, an incision of about 2 mm was made on the edge of the implant and it was bent to form a slot. A hole was made in the center of the implant for fitting a bone hook, and the implant was firmly fit into the remaining intact bone. Before and after surgery, computed tomography (CT) was used to evaluate changes in the orbital volume and the location of the implant. Statistically significant restoration of the orbital volume was confirmed on postoperative CT. Results: Compared with the unaffected orbital volume, the affected orbital volume was increased from 87.06 ± 7.92% before surgery to 96.14 ± 6.11% after surgery (p < 0.001). There was one case of implant migration during follow-up. However, the degree of movement was not severe, and there were no events during the follow-up period. Conclusions: The tongue-in-groove technique offers advantages, such as easy fixation of the implant, with minimal trauma to the surrounding tissues. In addition, the method offers advantages, such as being easy to learn, requiring little time for trimming the implant, and being relatively low cost. Therefore, it can be one of the options for implant fixation.

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Reconstructive Surgery

2023

Journal of Oral and Maxillofacial Surgery

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Preservation of Infraorbital Nerve in Orbital Floor and Maxillary Defect Reconstruction With Patient-Specific Three-Dimensional Implant: A Case Report

Abstract: FIG. 3. Preoperative image (A) and 8-month following surgery (B). Note the restoration of the maxillary prominence and orbitomaxillary contour. FIG. 4. Maxillofacial CT scan of large expansile mass involving the orbital floor and maxilla on axial (A) and sagittal (B) planes.

Cited by 3 publications

References 16 publications

Surface modification of PEEK implants for craniofacial reconstruction and aesthetic augmentation—fiction or reality?

Surface modification of PEEK implants for craniofacial reconstruction and aesthetic augmentation—fiction or reality?

Tongue-in-Groove: A Novel Implant Design for a Blow-Out Fracture

Reconstructive Surgery

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