Biomechanical comparison of titanium miniplates versus a variety of CAD/CAM plates in mandibular reconstruction

2020 ◽  
Vol 111 ◽  
pp. 104007
Author(s):  
Claudius Steffen ◽  
Kay Sellenschloh ◽  
Matthias Vollmer ◽  
Michael M. Morlock ◽  
Max Heiland ◽  
...  
Keyword(s):  
Mandibular Reconstruction ◽  
Cad Cam ◽  
Biomechanical Comparison

Biomechanical In Vitro Study on the Stability of Patient-Specific CAD/CAM Mandibular Reconstruction Plates: A Comparison Between Selective Laser Melted, Milled, and Hand-Bent Plates

2020 ◽  
pp. 194338752095268
Author(s):  
Robin Kasper ◽  
Karsten Winter ◽  
Sebastian Pietzka ◽  
Alexander Schramm ◽  
Frank Wilde
Keyword(s):  
In Vitro Study ◽  
Mandibular Reconstruction ◽  
Patient Specific ◽  
Plate Fracture ◽  
Computer Aided ◽  
Cad Cam ◽  
Number Of Cycles ◽  
Bent Plates ◽  
Cam Systems

Study Design: An experimental in vitro study. Objective: Plate fractures are a recurrent problem in alloplastic mandibular reconstruction. Hypothetically it can be assumed that computer-aided design (CAD)/computer-aided manufacturing (CAM) reconstruction plates have a higher stability than conventional hand-bent plates. The aim of the study was to compare additive and subtractive fabricated CAD/CAM mandibular reconstruction plates as well as conventional plates with regard to their biomechanical properties. Methods: In a chewing simulator, plates of 2 conventional locking plate systems and 2 CAD/CAM-fabricated plate systems were compared. The plates were loaded in a fatigue test. The maximum number of cycles until plate fracture and the plate stiffness were compared. Results: While all conventional plates fractured at a maximum load between 150 and 210 N (Newton) after a number of cycles between 40 000 and 643 000, none of the CAD/CAM plates broke despite a nearly doubled load of 330 N and 2 million cycles. Both CAD/CAM systems proved to be significantly superior to the hand-bent plates. There was no difference between the 2 CAD/CAM systems. Conclusions: Concerning the risk of plate fracture, patient-specific CAD/CAM reconstruction plates appear to have a significant advantage over conventional hand-bent plates in alloplastic mandibular reconstruction.

scholarly journals Computer-Assisted Mandibular Reconstruction using a Patient-Specific Reconstruction Plate Fabricated with Computer-Aided Design and Manufacturing Techniques

2014 ◽  
Vol 7 (2) ◽  
pp. 158-166 ◽  
Author(s):  
Frank Wilde ◽  
Carl-Peter Cornelius ◽  
Alexander Schramm
Keyword(s):  
Computer Aided Design ◽  
Mandibular Reconstruction ◽  
Patient Specific ◽  
Computer Assisted ◽  
Reconstruction Plate ◽  
Fibula Flap ◽  
Computer Aided ◽  
Cad Cam ◽  
Aided Design ◽  
Five Axis

We investigated the workflow of computer-assisted mandibular reconstruction that was performed with a patient-specific mandibular reconstruction plate fabricated with computer-aided design and computer-aided manufacturing (CAD/CAM) techniques and a fibula flap. We assessed the feasibility of this technique from virtual planning to the completion of surgery. Computed tomography (CT) scans of a cadaveric skull and fibula were obtained for the virtual simulation of mandibular resection and reconstruction using ProPlan CMF software (Materialise®/DePuy Synthes®). The virtual model of the reconstructed mandible provided the basis for the computer-aided design of a patient-specific reconstruction plate that was milled from titanium using a five-axis milling machine and CAM techniques. CAD/CAM techniques were used for producing resection guides for mandibular resection and cutting guides for harvesting a fibula flap. Mandibular reconstruction was simulated in a cadaveric wet laboratory. No problems were encountered during the procedure. The plate was fixed accurately to the residual bone without difficulty. The fibula segments were attached to the plate rapidly and reliably. The fusion of preoperative and postoperative CT datasets demonstrated high reconstruction precision. Computer-assisted mandibular reconstruction with CAD/CAM-fabricated patient-specific reconstruction plates appears to be a promising approach for mandibular reconstruction. Clinical trials are required to determine whether these promising results can be translated into successful practice and what further developments are needed.

Short-term outcomes of mandibular reconstruction in oncological patients using a CAD/CAM prosthesis including a condyle supporting a fibular free flap

2017 ◽  
Vol 45 (2) ◽  
pp. 330-337 ◽  
Author(s):  
Achille Tarsitano ◽  
Salvatore Battaglia ◽  
Valerio Ramieri ◽  
Piero Cascone ◽  
Leonardo Ciocca ◽  
...  
Keyword(s):  
Free Flap ◽  
Mandibular Reconstruction ◽  
Short Term ◽  
Oncological Patients ◽  
Cad Cam ◽  
Fibular Free Flap

scholarly journals Factors influencing CAD/CAM accuracy in fibula free flap mandibular reconstruction

2020 ◽  
Vol 40 (2) ◽  
pp. 138-143
Author(s):  
Ahmed Hassan Sweed ◽  
Alessandro Remigio Bolzoni ◽  
Aleksandra Kadubiec ◽  
Giada Anna Beltramini ◽  
Alessandro Cherchi ◽  
...  
Keyword(s):  
Free Flap ◽  
Mandibular Reconstruction ◽  
Factors Influencing ◽  
Fibula Free Flap ◽  
Cad Cam

CAD-CAM vs conventional technique for mandibular reconstruction with free fibula flap: A comparison of outcomes

2020 ◽  
Vol 34 ◽  
pp. 284-291 ◽  
Author(s):  
Sanjay Mahendru ◽  
Rahul Jain ◽  
Aditya Aggarwal ◽  
Hardeep S. Aulakh ◽  
Ankit Jain ◽  
...  
Keyword(s):  
Conventional Technique ◽  
Mandibular Reconstruction ◽  
Free Fibula Flap ◽  
Fibula Flap ◽  
Cad Cam ◽  
Free Fibula

Accuracy of fibular sectioning and insertion into a rapid-prototyped bone plate, for mandibular reconstruction using CAD-CAM technology

2015 ◽  
Vol 43 (1) ◽  
pp. 28-33 ◽  
Author(s):  
Leonardo Ciocca ◽  
Claudio Marchetti ◽  
Simona Mazzoni ◽  
Paolo Baldissara ◽  
Maria Rosaria Antonella Gatto ◽  
...  
Keyword(s):  
Mandibular Reconstruction ◽  
Bone Plate ◽  
Cad Cam

scholarly journals PEMAKAIAN MEDICAL RAPID PROTOTYPING UNTUK PREKONTUR PLAT REKONSTRUKSI PADA RESEKSI MANDIBULA

2017 ◽  
Vol 4 (2) ◽  
pp. 149
Author(s):  
Arya Kusuma Agraha ◽  
Masykur Rahmat ◽  
Rahardjo .
Keyword(s):  
Rapid Prototyping ◽  
Computer Aided Design ◽  
Mandibular Reconstruction ◽  
Reconstruction Plate ◽  
Mandibular Bone ◽  
Accurate Picture ◽  
Computer Aided ◽  
Long Time ◽  
Cad Cam ◽  
Aided Design

Background: In the case of mandibular resection that leaves a large mandibular bone defect, a mandibular reconstruction is required to restore functional and postoperative aesthetic factors. Mandibular reconstruction plate installation on mandibular resection is very important but difcult to achieve maximum results. The formation of reconstruction plates can be preoperative and intraoperative. Preoperative stereolithography (medical rapid prototyping/MRP) can be used to form rapid and accurate plates (precontours). Objective: Report the use of MRP as an alternative tool to precontour mandibular reconstruction plate.Case management: Reported reconstruction of mandibular defects in one case of hemimandibulectomy and two cases of segmental resection with avascular iliac bone grafts using MRP through a computer-aided design and computer aided manufacture procedure (CAD/CAM) to establish preoperative reconstruction plates (precontour) so the surgery doesn’t take long time to reconstruct, by forming a mandibular models under normal circumstances.Result: The formation of a reconstruction plates (precontour) using MRP (medical rapid prototyping) with CAD / CAM procedure gives results in accordance with the original form.Conclusions: The making of MRP through CAD / CAM procedure gives maximal result resembling the form of mandibular model. The MRP models get an accurate picture of the patient’s jaw as a pre contour tools for reconstruction plate. The formation of the reconstruction plates (precontour) with these MRP model is obtained from CAD / CAM and provides a normal jaw image, so that preoperative precontouring will give good and maximum result on the reconstruction plates made under the MRP models.

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