Correction of a Posttraumatic Orbital Deformity Using Three-Dimensional Modeling, Virtual Surgical Planning with Computer-Assisted Design, and Three-Dimensional Printing of Custom Implants

We describe a case of complex, posttraumatic skull and orbital deformities that were evaluated and treated with advanced computer technology, including virtual surgical planning, three-dimensional (3D) modeling, and printed patient custom implants (PCI) fabricated by 3D printing. A 50-year-old man presented to our craniofacial referral center 1 year after failed reduction of complex left orbital, zygomatic, and frontal bone fractures due to a motorcycle collision. The patient's chief complaint was debilitating diplopia in all fields of gaze. On examination, he had left enophthalmos, left canthal displacement, lower eyelid ectropion, vertical orbital dystopia, and a laterally and inferiorly displaced, comminuted zygoma with orbital rim and frontal bone defects. The normal orbit was mirrored to precisely guide repositioning of the globe, orbital reconstruction, and cranioplasty. Preinjury appearance with normal globe position was restored with complete resolution of diplopia. Modern 3D technology allows the surgeon to better analyze complex orbital deformities and precisely plan surgical correction with the option of printing a PCI. These techniques were successfully applied to resolve a case of debilitating diplopia and aesthetic deficits after facial trauma. Further application of advanced 3D computer technology can potentially improve the results of severe orbital and craniofacial trauma reconstruction.

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EPPOCRATIS: A Point-of-Care Utilization of Virtual Surgical Planning and Three-Dimensional Printing for the Management of Acute Craniomaxillofacial Trauma

Journal of Clinical Medicine ◽

10.3390/jcm10235640 ◽

2021 ◽

Vol 10 (23) ◽

pp. 5640

Author(s):

Basel A. Sharaf ◽

Jonathan M. Morris ◽

Doga Kuruoglu

Keyword(s):

Surgical Planning ◽

Point Of Care ◽

Three Dimensional ◽

Care Utilization ◽

Facial Trauma ◽

Trauma Management ◽

Three Dimensional Printing ◽

Craniomaxillofacial Surgery ◽

Virtual Surgical Planning ◽

Craniomaxillofacial Trauma

While virtual surgical planning (VSP) and three-dimensional planning (3DP) have become important tools in acute craniomaxillofacial surgery, the incorporation of point of care VSP and 3DP is crucial to allow for acute facial trauma care. In this article, we review our approach to acute craniomaxillofacial trauma management, EPPOCRATIS, and discuss current challenges and future directions in acute facial trauma management.

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Iatrogenic Displaced Maxillary Third Molar Tooth

Journal of KIST Medical College ◽

10.3126/jkistmc.v2i2.33779 ◽

2020 ◽

Vol 2 (2) ◽

pp. 84-86

Author(s):

Surendra Kumar Acharya ◽

Ongkila Bhutia ◽

Ajoy Roychoudhury ◽

Rahul Yadav ◽

Ankit Arora ◽

...

Keyword(s):

Surgical Planning ◽

Three Dimensional ◽

Third Molar ◽

Computer Assisted ◽

Know How ◽

Virtual Surgical Planning ◽

Third Molar Extraction ◽

Position And Orientation ◽

Upper Third ◽

Molar Extraction

Minor to major complications may occur during the third molar extraction but should be optimized. Surgeons should know how to diagnose the case and manage the complications. We hereby report one of the rare complications of upper third molar extraction; iatrogenic displacement in infratemporal space. We emphasized hence on management of such technically sensitive case using 3D virtual surgical planning. The use of computer-assisted three-dimensional surgical planning to reconstruct the tooth in its localized position and orientation makes the operation more accurate, more convenient, and avoids damage to vital structures.

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The Use of Virtual Surgical Planning in Total Facial Skeletal Reconstruction of Treacher Collins Syndrome: A Case Report

Craniomaxillofacial Trauma & Reconstruction ◽

10.1055/s-0037-1604424 ◽

2018 ◽

Vol 11 (3) ◽

pp. 230-237 ◽

Cited By ~ 1

Author(s):

Yifan Guo ◽

Joseph Lopez ◽

Robin Yang ◽

Alexandra Macmillan ◽

Amir H. Dorafshar

Keyword(s):

Case Report ◽

Orthognathic Surgery ◽

Surgical Planning ◽

Three Dimensional ◽

Treacher Collins Syndrome ◽

Computer Assisted ◽

Craniofacial Abnormalities ◽

Virtual Surgical Planning ◽

Facial Harmony ◽

Skeletal Reconstruction

Facial skeletal reconstruction of patients with severe Treacher Collins syndrome (TCS) requires correction of both midface and mandibular deficiencies. Implementing virtual surgical planning can provide an accurate three-dimensional analysis of craniofacial abnormalities, creating calvarial donors that match the anatomy of the desired malar augmentation and facilitating bimaxillary movements, positioning, and fixation in orthognathic surgery. We present a case of an 18-year-old patient with TCS, who underwent staged zygomaticomaxillary reconstruction and double-jaw osteotomy with sliding genioplasty, using computer-assisted surgical planning. Following these operations, the patient achieved not only improved facial harmony but also class I occlusion.

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

Journal of Clinical Medicine ◽

10.3390/jcm10091922 ◽

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.

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