Medial approach for minimally-invasive harvesting of a deep circumflex iliac artery flap for reconstruction of the jaw using virtual surgical planning and CAD/CAM technology

2017 ◽  
Vol 55 (9) ◽  
pp. 946-951 ◽  
Author(s):  
A. Modabber ◽  
N. Ayoub ◽  
A. Bock ◽  
S.C. Möhlhenrich ◽  
B. Lethaus ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Iliac Artery ◽  
Surgical Planning ◽  
Medial Approach ◽  
Virtual Surgical Planning ◽  
Deep Circumflex Iliac Artery ◽  
Cad Cam

scholarly journals Virtual Surgical Planning of Deep Circumflex Iliac Artery Flap for Midface Reconstruction

2021 ◽  
Vol 11 ◽  
Author(s):  
Yi-Fan Kang ◽  
Xiao-Ming Lv ◽  
Shi-Yu Qiu ◽  
Meng-Kun Ding ◽  
Shang Xie ◽  
...  
Keyword(s):  
Iliac Artery ◽  
Surgical Planning ◽  
Implantation Rate ◽  
Titanium Implants ◽  
Vascular Anastomosis ◽  
Computer Assisted ◽  
Virtual Surgical Planning ◽  
Dental Implantation ◽  
Deep Circumflex Iliac Artery ◽  
Midface Reconstruction

ObjectiveMidface reconstruction is challenging for functional and esthetic reasons. The present study analyzed the effect of virtual surgical planning (VSP) of the deep circumflex iliac artery (DCIA) flap for midface reconstruction.Patients and MethodsThirty-four patients who underwent midface reconstruction with the DCIA flap were included in this retrospective study. Of the 34 patients, 16 underwent preoperative VSP, which used a three-dimensionally printed surgical guide, computer-assisted navigation system, and pre-bent titanium implants to transfer VSP into real-world surgery. The other 18 patients underwent traditional midface reconstruction. The following were compared between the two groups: bony contact rate in the buttress region (BCR), dental arch reconstruction rate (DAR), surgical approach, position of vascular anastomosis, and dental implantation rate. The independent-samples t-test and Fisher’s exact test were used for analysis. P < 0.05 was considered statistically significant.ResultsIn total, 12 males and 22 females were included in this study. All patients underwent midface reconstruction using the DCIA flap at the same institution. The median age of patients was 33 years (range: 16–68 years). The average BCR and DAR values in the VSP group were 59.4% ± 27.9% and 87.5% ± 18.9%, respectively, which were significantly higher compared with the non-VSP group (P = 0.049 and P = 0.004, respectively). The dental implantation rate in the VSP group (50.0%) was significantly higher compared with the non-VSP group (11.1%; P = 0.023). The intraoral approach for tumor ablation and vascular anastomosis was the most frequent choice in both groups. There was no significant difference between the two groups. All patients were satisfied with facial symmetry postoperatively.ConclusionsVSP could effectively augment the effect of midface reconstruction with the DCIA flap. Stronger bone contact in the buttress region and higher DAR provide more opportunity for dental implantation, which might be the best solution to improve masticatory function in patients with midface defects.

scholarly journals The Use of a CAD/CAM Surgical Obturator Without Impressions to Restore a Maxillectomy Defect

2021 ◽  
Vol 6 ◽  
pp. 247275122199297
Author(s):  
Nicholas Callahan ◽  
Sarah L. Moles ◽  
Michael R. Markiewicz
Keyword(s):  
Surgical Planning ◽  
Tumor Resection ◽  
Free Tissue Transfer ◽  
Digital Impression ◽  
Head And Neck Reconstruction ◽  
Autologous Reconstruction ◽  
Form And Function ◽  
Virtual Surgical Planning ◽  
Tissue Transfer ◽  
Cad Cam

Immediate obturation of the patient undergoing maxillectomy who is not undergoing formal autologous reconstruction is important for immediate form and function of the patient. Exophytic tumors, that are large in dimension can make pre-operative obturator formation challenging. Traditional methods of obturator fabrication involve a physical or digital impression. Preoperative virtual surgical planning for tumor resection and reconstruction using free tissue transfer has become a mainstay in head and neck reconstruction. We describe a variation of this for a patient unable to undergo free tissue transfer where the authors used preoperative virtual surgical planning and CAD/CAM technologies to perform tumor resection, and fabricated an obturator based on the CT imaging alone.

scholarly journals Virtual Surgical Planning, Stereolitographic Models and CAD/CAM Titanium Mesh for Three-Dimensional Reconstruction of Fibula Flap with Iliac Crest Graft and Dental Implants

2021 ◽  
Vol 10 (9) ◽  
pp. 1922
Author(s):  
Carlos Navarro Cuéllar ◽  
Manuel Tousidonis Rial ◽  
Raúl Antúnez-Conde ◽  
Santiago Ochandiano Caicoya ◽  
Ignacio Navarro Cuéllar ◽  
...  
Keyword(s):  
Bone Resorption ◽  
Surgical Planning ◽  
Iliac Crest ◽  
Three Dimensional ◽  
Titanium Mesh ◽  
Iliac Crest Graft ◽  
Virtual Surgical Planning ◽  
Fibula Flap ◽  
Dimensional Reconstruction ◽  
Cad Cam

Mandibular reconstruction with fibula flap shows a 3D discrepancy between the fibula and the remnant mandible. Eight patients underwent three-dimensional reconstruction of the fibula flap with iliac crest graft and dental implants through virtual surgical planning (VSP), stereolitographic models (STL) and CAD/CAM titanium mesh. Vertical ridge augmentation and horizontal dimensions of the fibula, peri-implant bone resorption of the iliac crest graft, implant success rate and functional and aesthetic results were evaluated. Vertical reconstruction ranged from 13.4 mm to 10.1 mm, with an average of 12.22 mm. Iliac crest graft and titanium mesh were able to preserve the width of the fibula, which ranged from 8.9 mm to 11.7 mm, with an average of 10.1 mm. A total of 38 implants were placed in the new mandible, with an average of 4.75 ± 0.4 implants per patient and an osseointegration success rate of 94.7%. Two implants were lost during the osseointegration period (5.3%). Bone resorption was measured as peri-implant bone resorption at the mesial and distal level of each implant, with a variation between 0.5 mm and 2.4 mm, and with a mean of 1.43 mm. All patients were rehabilitated with a fixed implant prosthesis with good aesthetic and functional results.

scholarly journals Total joint reconstruction using computer-assisted surgery with stock prostheses for a patient with bilateral TMJ ankylosis

2019 ◽  
Vol 41 (1) ◽  
Author(s):  
Seung-Hyun Rhee ◽  
Seung-Hak Baek ◽  
Sang-Hun Park ◽  
Jong-Cheol Kim ◽  
Chun-Gi Jeong ◽  
...  
Keyword(s):  
Surgical Planning ◽  
Virtual Surgery ◽  
Computer Assisted ◽  
Lower Margin ◽  
Tmj Ankylosis ◽  
Reconstruction Surgery ◽  
Joint Reconstruction ◽  
Virtual Surgical Planning ◽  
Surgical Guides ◽  
Cad Cam

Abstract Backgrounds The purpose of this study is to discuss the total joint reconstruction surgery for a patient with recurrent ankylosis in bilateral temporomandibular joints (TMJs) using three-dimensional (3D) virtual surgical planning, computer-aided manufacturing (CAD/CAM)-fabricated surgical guides, and stock TMJ prostheses. Case presentation A 66-year-old female patient, who had a history of multiple TMJ surgeries, complained of severe difficulty in eating and trismus. The 3D virtual surgery was performed with a virtual surgery software (FACEGIDE, MegaGen implant, Daegu, South Korea). After confirmation of the location of the upper margin for resection of the root of the zygoma and the lower margin for resection of the ankylosed condyle, and the position of the fossa and condyle components of stock TMJ prosthesis (Biomet, Jacksonville, FL, USA), the surgical guides were fabricated with CAD/CAM technology. Under general anesthesia, osteotomy and placement of the stock TMJ prosthesis (Biomet) were carried out according to the surgical planning. At 2 months after the operation, the patient was able to open her mouth up to 30 mm without complication. Conclusion For a patient who has recurrent ankylosis in bilateral TMJs, total joint reconstruction surgery using 3D virtual surgical planning, CAD/CAM-fabricated surgical guides, and stock TMJ prostheses may be an effective surgical treatment option.

scholarly journals Virtual Surgical Planning and Piezoelectric Surgery in Tumor Extirpative Surgery Aimed at Inferior Alveolar Nerve Preservation

2017 ◽  
Vol 2017 ◽  
pp. 1-6
Author(s):  
Eric L. Chung ◽  
Faizan Alawi ◽  
Anh D. Le ◽  
Rabie M. Shanti
Keyword(s):  
Computer Aided Design ◽  
Surgical Planning ◽  
Inferior Alveolar Nerve ◽  
Benign Tumors ◽  
Ossifying Fibroma ◽  
Nerve Preservation ◽  
Virtual Surgical Planning ◽  
Piezoelectric Surgery ◽  
Computer Aided ◽  
Cad Cam

A myriad of extirpative surgical protocols for the management of benign tumors of the jaws have been presented in the literature. Through significant advancements in computer-aided design and computer-aided manufacturing (CAD/CAM) technology and surgical instrumentation, today surgeons have at their disposal robust technology-driven techniques that are aimed at improving surgical outcomes. Our goal is to investigate the benefits of implementing virtual surgical planning (VSP) in conjunction with piezoelectric surgery (PES) to ensure success while minimizing the risk of complications during extirpation of tumors of the mandible. This case report describes the successful extirpation of an ossifying fibroma of the mandible in an adult patient using both VSP and PES.

scholarly journals The Role of Virtual Surgical Planning in Increasing the Predictability in Orthognathic Surgery

2019 ◽  
pp. 136-141
Author(s):  
Faisal A Quereshy ◽  
Nikolay Levintov ◽  
Justin L Nguyen ◽  
Maria A DeLeonibus ◽  
Catherine Demko ◽  
...  
Keyword(s):  
Surgical Outcomes ◽  
Orthognathic Surgery ◽  
Surgical Planning ◽  
Predictor Variable ◽  
Outcome Variable ◽  
Virtual Surgical Planning ◽  
Equal Variance ◽  
Modeling Software ◽  
Cad Cam ◽  
Medical Modeling

Purpose: To evaluate our surgical outcomes by comparing our surgical plan to the outcome of the surgery and evaluate our efficacy using Virtual Surgical Planning and Medical Modeling software. Our aim is to determine the quality and validity of Virtual Surgical Planning when comparing pre-surgical plans with post-surgical outcomes. Patients and Methods: A cohort study was conducted for patients who underwent orthognathic surgery at a single institution.  Utilizing virtual plans and models, select points for the virtual plans were compared and superimposed with that of the actual surgical movements.  The primary predictor variable were the pre-surgical virtual plans of movements; the outcome variable consisted of the actual post-surgical movements.  Statistical analysis was computed via IBM SPSS Version 25 software utilizing a paired t-test assuming equal variance with alpha (p<0.05). The sample of patients included those who had pre-operative and post-operative cone beam computed tomography scans, a virtual surgical plan, CAD/CAM splints, and LeFort I osteotomy and bilateral sagittal split osteotomy.Results: The study consisted of ten patients between the ages of 18-51 years old. Pre and post surgical plans were superimposed and four points of measurement were compared along 3 dimensional planes. There were no statistical significant associations between the virtually planned and post surgical planned values.Conclusion: Our results suggest that the use of virtual surgical planning in orthognathic surgery yields favorable and accurate surgical outcomes regarding rotational movements with minor degrees of discrepancies.

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