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 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 Digital planning and guided surgery in oral rehabilitation

2020 ◽  
Author(s):  
Larissa Braga dos Santos ◽  
Adriano Relvas Barreira de Oliveira ◽  
Mauro Lefrançois ◽  
Marcos Venício Azevedo ◽  
Pablo Sotelo ◽  
...  
Keyword(s):  
Surgical Planning ◽  
Three Dimensional ◽  
Oral Rehabilitation ◽  
Digital Workflow ◽  
Surgical Guide ◽  
Surgical Guides ◽  
Digital Planning ◽  
Cad Cam ◽  
Correct Understanding ◽  
Plaster Model

Digital planning of the prosthesis associated with surgical planning increased predictability, since surgical guides indicate the best place for implant installation, thus reducing the number of complications, and the CAD/CAM system provides predictability in the preparation of final restorations, according to the procedure previously planned. Our study reported a digital workflow used for the guided installation of two dental implants in regions 14 and 16, extraction of tooth 15 and installation of a fixed prothesis over implants. After anamnesis and clinical evaluation, intra- and extra-oral photographs of the patient were performed, molding the upper arch with polyvinylsiloxane (2-step putty/light-body technique) and requesting computed tomography. The plaster model obtained was sent to the laboratory and scanned. The generated file (STL) was used to create a diagnostic wax-up that was aligned to the tomography (in DICOM format), enabling the three-dimensional planning of the implants, which generated a partial printed surgical guide after approval of the dentist. After six months, the patient received the provisional fixed prosthesis printed in PMMA (polymethylmethacrylate) on an intermediate in PEEK (polyetheretherketone) aiming to condition an emergency profile to receive a definitive prosthesis two months later, with zirconia-milled infrastructure on a ti-base. The correct understanding of the operator about the steps of the digital workflow (diagnosis, prosthetic planning, surgical planning, guide preparation, temporary and final restorations) gives the operator improved predictability at the time of surgery as well as satisfactory aesthetic and functional result of definitive restorations.

Accuracy Assessment of Immediate and Delayed Implant Placements Using CAD/CAM Surgical Guides

2016 ◽  
Vol 42 (5) ◽  
pp. 391-398 ◽  
Author(s):  
Fawaz Alzoubi ◽  
Nima Massoomi ◽  
Anders Nattestad
Keyword(s):  
Accuracy Assessment ◽  
Computer Assisted ◽  
Apical Position ◽  
Surgical Guides ◽  
Computer Assisted Design ◽  
Significant Difference ◽  
Cad Cam ◽  
Delayed Group ◽  
Immediate Implant ◽  
Delayed Implant Placement

The aim of this study is to assess the accuracy of immediately placed implants using Anatomage Invivo5 computer-assisted design/computer-assisted manufacturing (CAD/CAM) surgical guides and compare the accuracy to delayed implant placement protocol. Patients who had implants placed using Anatomage Invivo5 CAD/CAM surgical guides during the period of 2012–2015 were evaluated retrospectively. Patients who received immediate implant placements and/or delayed implant placements replacing 1–2 teeth were included in this study. Pre- and postsurgical images were superimposed to evaluate deviations at the crest, apex, and angle. A total of 40 implants placed in 29 patients were included in this study. The overall mean deviations measured at the crest, apex, and angle were 0.86 mm, 1.25 mm, and 3.79°, respectively. The means for the immediate group deviations were: crest = 0.85 mm, apex = 1.10, and angle = 3.49°. The means for the delayed group deviations were: crest = 0.88 mm, apex = 1.59, and angle = 4.29°. No statistically significant difference was found at the crest and angle; however, there was a statistically significant difference between the immediate and delayed group at the apex, with the immediate group presenting more accurate placements at the apical point than the delayed group. CAD/CAM surgical guides can be reliable tools to accurately place implants immediately and/or in a delayed fashion. No statistically significant differences were found between the delayed and the immediate group at the crest and angle, however apical position was more accurate in the immediate group.

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

2018 ◽  
Vol 11 (1) ◽  
pp. 078-082 ◽  
Author(s):  
Kristopher M. Day ◽  
Paul M. Phillips ◽  
Larry A. Sargent
Keyword(s):  
Computer Technology ◽  
Surgical Planning ◽  
Bone Fractures ◽  
Three Dimensional ◽  
Lower Eyelid ◽  
Frontal Bone ◽  
Facial Trauma ◽  
Computer Assisted ◽  
Virtual Surgical Planning ◽  
Three Dimensional Modeling

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.

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.

scholarly journals Prevention of Mandible Fractures in Medication-Related Osteonecrosis of the Jaws: The Role of Virtual Surgical Planning and Computer-Aided Design and Manufacturing in Two Clinical Case Reports

2021 ◽  
Vol 11 (17) ◽  
pp. 7894
Author(s):  
João André Correia ◽  
José Ricardo Ferreira ◽  
Miguel Amaral Nunes ◽  
António Capelo ◽  
Miguel de Araújo Nobre ◽  
...  
Keyword(s):  
Computer Aided Design ◽  
Surgical Planning ◽  
Necrotic Bone ◽  
Osteonecrosis Of The Jaws ◽  
Virtual Surgical Planning ◽  
Mandible Fracture ◽  
Computer Aided ◽  
Cad Cam ◽  
Mandible Fractures ◽  
Aided Design

Background: Marginal mandible resection is required to achieve healing in some cases of medication-related osteonecrosis of the jaws (MRONJ). Despite the sparsity of the literature, computer-aided design/computer-aided manufacturing (CAD/CAM) materials may provide superior outcomes for patients with an increased risk of mandible fracture. The aim of this study was to report a digital workflow for surgical interventions to prevent mandible fracture in MRONJ patients. Methods: We present two cases in which virtual surgical planning (VSP) and CAD/CAM surgical guides and reconstruction plates were used to prevent mandible fractures in elderly MRONJ patients submitted for marginal resection. Two osteoporotic patients, aged 73 and 84 years, presented with stage 3 MRONJ of the right mandibular body with inferior alveolar nerve involvement. The unaffected bone height was 6 mm in both cases, implying a high risk of mandible fracture. After preoperative VSP, surgery was performed through a combined intraoral–transbuccal approach. CAD/CAM-customized cutting guides and reconstruction plates were used for the marginal resection of necrotic bone and internal fixation. Results: Complete healing was achieved and the patients remained asymptomatic up to 1 year post-surgery. Conclusions: VSP and CAD/CAM-customized materials facilitated the complete resection of necrotic bone and rigid fixation in MRONJ patients, allowing a simplified approach with shorter operative times, reduced morbidity, and predictable results.

Sign in / Sign up

Export Citation Format

Share Document