scholarly journals Aesthetical and Accuracy Outcomes of Reconstruction of Maxillary Defect by 3D Virtual Surgical Planning

2021 ◽  
Vol 11 ◽  
Author(s):  
Yang Wang ◽  
Xingzhou Qu ◽  
Junjian Jiang ◽  
Jian Sun ◽  
Chenping Zhang ◽  
...  
Keyword(s):  
3D Printing ◽  
Surgical Planning ◽  
Statistical Significance ◽  
Clinical Information ◽  
Hand Surgery ◽  
Class Iii ◽  
Normal Side ◽  
Virtual Surgical Planning ◽  
Maxillary Defect ◽  
The Mean

BackgroundReconstruction of maxillary defect resulting from trauma or oncology surgery is of great importance for patients with physical and psychological complications. The virtual surgical planning (VSP) and 3D printing technics had been used in recent years which simplified the surgical procedure and promoted success and accuracy. To assess the accuracy and outcome of VSP surgery, here we report our experience in maxillary reconstruction retrospectively.MethodPatients who received maxillary defect reconstruction from 2013 to 2020 were analyzed retrospectively. These patients were divided into two groups. Group 1 received VSP and 3D printed guiding plates in the surgery, while group 2 underwent free-hand surgery (FHS). Patients with different vertical and horizontal defects were classified according to Brown and Shaw classification. Clinical information and postoperative complications of all patients were collected. For patients with unilateral maxillary defect, orbit volume, orbit height, and the contour of the reconstructed side were compared with the normal side.ResultThirty-four patients who achieved the criteria were analyzed, of which 20 patients underwent VSP surgery. There were primary and secondary reconstruction cases in both two groups. Vascularized iliac crest flap was used in three cases, and fibula flap was performed in the other cases. One flap collapse occurred in FHS group. Seven patients in VSP group received dental implants, while the number in FHS group was 0. In vertical class III cases, the differences in orbit height (ΔD) and orbit volume (ΔV) between normal side and reconstructed side were measured and compared in the two groups. The mean ΔD is 1.78 ± 1.33 mm in VSP group and 4.25 ± 0.95 mm in FHS group, while the mean ΔV is 2.04 ± 0.85 cm3 in VSP group and 3.25 ± 0.17 cm3 in FHS group. The alterations of orbit height and volume in VSP group were much smaller than that in FHS group with statistical significance. From the perspective of aesthetics, the color-gradient map indicates a more symmetric and smoother curve of post-operation appearance in VSP group.ConclusionCompared with traditional free-hand surgical technics, VSP and 3D printing guiding plates can allow for a more accurate maxillary reconstruction with improved aesthetics.

scholarly journals Point of care virtual surgical planning and 3D printing in facial gender confirmation surgery: a narrative review

2021 ◽  
Vol 9 (7) ◽  
pp. 614-614
Author(s):  
Doga Kuruoglu ◽  
Maria Yan ◽  
Samyd S. Bustos ◽  
Jonathan M. Morris ◽  
Amy E. Alexander ◽  
...  
Keyword(s):  
3D Printing ◽  
Surgical Planning ◽  
Point Of Care ◽  
Narrative Review ◽  
Virtual Surgical Planning

Virtual surgical planning: Balancing esthetics, practicality, and anticipated stability in a complex Class III patient

2019 ◽  
Vol 156 (5) ◽  
pp. 685-693 ◽  
Author(s):  
Éva Veiszenbacher ◽  
Jue Wang ◽  
Matthew Davis ◽  
Peter D. Waite ◽  
Peter Borbély ◽  
...  
Keyword(s):  
Surgical Planning ◽  
Complex Class ◽  
Class Iii ◽  
Virtual Surgical Planning

scholarly journals Virtual Surgical Planning for the Management of Severe Atrophic Mandible Fractures

2018 ◽  
Vol 11 (2) ◽  
pp. 150-156 ◽  
Author(s):  
Jaime Castro-Núñez ◽  
Jared M. Shelton ◽  
Susan Snyder ◽  
JosephVan Sickels
Keyword(s):  
Surgical Planning ◽  
Treatment Time ◽  
Three Dimensional ◽  
Pathologic Fracture ◽  
Ct Scans ◽  
Class Iii ◽  
Computed Tomographic ◽  
Virtual Surgical Planning ◽  
Three Dimensional Models ◽  
Mandible Fractures

Severely atrophic mandible fractures are frequently a challenge to treat. Virtual surgical planning (VSP) uses three-dimensional computed tomographic (CT) scans that can be translated into stereolithographic models to fabricate surgical templates, facilitating intraoperative procedures. The purpose of this article is to describe the reconstruction of two cases of severe atrophic mandible fracture using VSP. Two elderly edentulous/partially dentate patients who presented with fractures of their mandibles and who underwent reconstruction using VSP were included. Both had Class III atrophy at the region of the fracture. While both fractures were complex, the mechanism of injury differed with one being a tractor accident and the other being a pathologic fracture. Both patients presented with critical medical conditions. CT scans were obtained on both. The displaced segments were aligned virtually using mirror images and the midline of the maxilla. Three-dimensional models were fabricated to allow preoperative contouring of 2.5-mm reconstruction plates. Patients were operated under general anesthesia and fractures reduced and stabilized with 2.5-mm reconstruction plates placed at the lateral border of the mandible. Average treatment time for both patients was a little over 2 hours. There was good reduction with both. VSP is a valuable tool to assess and reduce complex fractures with less surgical time and predictable results.

Comparative clinical evaluation of slot versus dovetail Class III composite restorations in primary anterior teeth

2005 ◽  
Vol 28 (2) ◽  
pp. 125-129 ◽  
Author(s):  
Chutima Trairatvorakul ◽  
Supatcharin Piwat
Keyword(s):  
Clinical Characteristics ◽  
Statistical Significance ◽  
Kappa Statistic ◽  
Marginal Adaptation ◽  
Matched Pairs ◽  
Class Iii ◽  
Anterior Teeth ◽  
The Mean ◽  
The Difference ◽  
Clinical Characteristic

This study compares the clinical characteristic evaluations of slot against dovetail class III composite restorations.Focusing on the primary anterior teeth of children aged 2 years 6 months to 5 years 3 months with the mean age of 4 years, thirty-six matched pairs of class III of slot and dovetail preparations were made by one investigator. These preparations were evaluated for marginal adaptation, anatomic form, secondary caries and marginal discoloration after 6, 12, and 24 months by another investigator with the intra-examiner reliability of 0.95 – 1 (Kappa Statistic). The results revealed no statistical significance in the difference of clinical characteristics between the two designs (p > 0.05).

scholarly journals 4360 Black Bone MRI from the Lab to Clinical Practice: Eliminating Radiation Exposure in Reconstructive Surgery Patients

2020 ◽  
Vol 4 (s1) ◽  
pp. 105-106
Author(s):  
Marissa Suchyta ◽  
Christopher Hunt ◽  
Waleed Gibreel ◽  
Diya Sabbagh ◽  
Kryzysztof Gorny ◽  
...  
Keyword(s):  
3D Printing ◽  
Radiation Exposure ◽  
Reconstructive Surgery ◽  
Surgical Planning ◽  
Clinical Care ◽  
Ct Scans ◽  
Patient Specific ◽  
Average Deviation ◽  
Virtual Planning ◽  
Virtual Surgical Planning

OBJECTIVES/GOALS: Virtual surgical planning and 3D printing enable streamlined surgeries and increased complexity. These technologies, however, require CT scans and radiation exposure. This project’s goal is to optimize and demonstrate the accuracy of Black Bone MRI for surgical planning in reconstructive surgery. METHODS/STUDY POPULATION: Four common craniofacial surgeries were planned and performed on cadaver specimens (maxillary advancement, orbital floor reconstruction with patient-specific implants, cranial vault reconstruction, and fibular free flap reconstruction of the mandible). For each surgical procedure, ten cadaver heads were used. Five of each surgery were planned and 3D printed guides were created utilizing Black Bone MRI versus five with CT scans. Following mock surgeries, all specimens underwent a post-operative CT scan. 3d reconstruction was performed and surgical accuracy compared to the plan was assessed using GeoMagic Wrap, assessing average post-operative deviation from plan. RESULTS/ANTICIPATED RESULTS: In all surgeries, guides created from Black Bone MRI demonstrated high accuracy to surgical plan. Average osteotomy (cut) deviation from plan was not statistically significantly different when Black Bone MRI was used compared to CT scans for planning and guide creation in the wide variety of craniofacial surgeries performed. The average deviation of post-operative anatomy from pre-operative plan was also not statistically significant when Black Bone MRI versus CT scans were utilized in the surgeries. These results then enabled the translational application of this technology clinically, and we demonstrate a clinical reconstructive craniofacial case planned utilizing Black Bone MRI. DISCUSSION/SIGNIFICANCE OF IMPACT: This study demonstrates that virtual surgical planning and 3d surgical guide creation can be performed using Black Bone MRI with comparable accuracy to CT scans in a wide variety of craniofacial procedures. This could dramatically reduce radiation exposure for patients. The successful segmentation, virtual planning, and 3d printing of accurate guides from Black Bone MRI demonstrate potential to change the pre-operative planning standard of care. This project, overall, also demonstrates the development of new solutions to advance clinical care, thus serving as an example of moving translational science from a concept to the operating room.

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