scholarly journals Computer-Assisted Surgery for Mandibular Reconstruction Using a Patient-Specific Titanium Mesh Tray and Particulate Cancellous Bone and Marrow

2015 ◽  
Vol 04 (03) ◽  
pp. 85-92
Author(s):  
Seiji Kondo ◽  
Hideyuki Katsuta ◽  
Ayako Akizuki ◽  
Yuji Kurihara ◽  
Takaaki Kamatani ◽  
...  
Keyword(s):  
Cancellous Bone ◽  
Computer Assisted Surgery ◽  
Mandibular Reconstruction ◽  
Patient Specific ◽  
Computer Assisted ◽  
Titanium Mesh

scholarly journals Comparison of the Accuracy and Clinical Parameters of Patient-Specific and Conventionally Bended Plates for Mandibular Reconstruction

2021 ◽  
Vol 11 ◽  
Author(s):  
Henriette L. Möllmann ◽  
Laura Apeltrath ◽  
Nadia Karnatz ◽  
Max Wilkat ◽  
Erik Riedel ◽  
...  
Keyword(s):  
Computer Assisted Surgery ◽  
Reference Points ◽  
Mandibular Reconstruction ◽  
Patient Specific ◽  
Computer Assisted ◽  
Advantages And Disadvantages ◽  
Patient Specific Implants ◽  
Operative Complications ◽  
The Difference ◽  
And Training

ObjectivesThis retrospective study compared two mandibular reconstruction procedures—conventional reconstruction plates (CR) and patient-specific implants (PSI)—and evaluated their accuracy of reconstruction and clinical outcome.MethodsOverall, 94 patients had undergone mandibular reconstruction with CR (n = 48) and PSI (n = 46). Six detectable and replicable anatomical reference points, identified via computer tomography, were used for defining the mandibular dimensions. The accuracy of reconstruction was assessed using pre- and postoperative differences.ResultsIn the CR group, the largest difference was at the lateral point of the condyle mandibulae (D2) -1.56 mm (SD = 3.8). In the PSI group, the largest difference between preoperative and postoperative measurement was shown at the processus coronoid (D5) with +1.86 mm (SD = 6.0). Significant differences within the groups in pre- and postoperative measurements were identified at the gonion (D6) [t(56) = -2.217; p = .031 <.05]. In the CR group, the difference was 1.5 (SD = 3.9) and in the PSI group -1.04 (SD = 4.9). CR did not demonstrate a higher risk of plate fractures and post-operative complications compared to PSI.ConclusionFor reconstructing mandibular defects, CR and PSI are eligible. In each case, the advantages and disadvantages of these approaches must be assessed. The functional and esthetic outcome of mandibular reconstruction significantly improves with the experience of the surgeon in conducting microvascular grafts and familiarity with computer-assisted surgery. Interoperator variability can be reduced, and training of younger surgeons involved in planning can be reaching better outcomes in the future.

scholarly journals Mandibular Reconstruction Using ProPlan CMF: A Review

2017 ◽  
Vol 1 (1) ◽  
pp. s-0037-1606835 ◽  
Author(s):  
Ryo Sasaki ◽  
Michael Rasse
Keyword(s):  
Computer Assisted Surgery ◽  
Mandibular Reconstruction ◽  
Patient Specific ◽  
Computer Assisted ◽  
Planning Service ◽  
Virtual Planning ◽  
Surgical Guide ◽  
Surgical Guides ◽  
Computer Aided

ProPlan CMF (Depuy Synthes, Solothurn, Switzerland, and Materialise, Leuven, Belgium) is a computer-aided surgical virtual planning service using an online meeting with professional medical engineers and transfers patient-specific surgical guide to the virtual plan. Moreover, prebent reconstruction plates or patient-specific computer-aided manufacturing-fabricated reconstruction can also be used. This service started in 2011. Currently, it is widely used in Europe. Current status of mandibular reconstruction with ProPlan CMF vertical planning service with the surgical guide was reviewed. The accuracy was excellent in terms of contact of the osteotomized parts and the contact to the remaining skeleton. The authors found that currently, a small number of reports regarding the mandibular reconstruction with virtual planning service and surgical guides are available. These reports also have a small number of cases and short-term follow-up results. In this situation, this review revealed that (1) mainly the resection guides, cutting guides, and patient-specific mandible reconstruction plates were adequately well fitted to the surgical site intraoperatively, (2) the ischemic time might be more reduced than that of the conventional surgery (3) the accuracy of computer-assisted surgery in the mandibular reconstruction was clinically acceptable, and (4) condyle positions after the computer-assisted surgery was mainly normal. The higher additional cost than that of the conventional technique is presently an issue. Large-scale clinical studies and long-term follow-up studies are demanded.

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.

Accuracy of computer-assisted surgery in mandibular reconstruction: A systematic review

Oral Oncology ◽  
2018 ◽  
Vol 84 ◽  
pp. 52-60 ◽  
Author(s):  
Gustaaf J.C. van Baar ◽  
Tymour Forouzanfar ◽  
Niels P.T.J. Liberton ◽  
Henri A.H. Winters ◽  
Frank K.J. Leusink
Keyword(s):  
Systematic Review ◽  
Computer Assisted Surgery ◽  
Mandibular Reconstruction ◽  
Computer Assisted

scholarly journals Accuracy of Patient Specific Cutting Blocks in Total Knee Arthroplasty

2014 ◽  
Vol 2014 ◽  
pp. 1-10 ◽  
Author(s):  
Naeder Helmy ◽  
Mai Lan Dao Trong ◽  
Stefanie P. Kühnel
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Computer Assisted Surgery ◽  
Tibial Slope ◽  
Patient Specific ◽  
Computer Assisted ◽  
Success Rates ◽  
Term Survival ◽  
Margin Of Error ◽  
Total Knee

Background.Long-term survival of total knee arthroplasty (TKA) is mainly determined by optimal positioning of the components and prosthesis alignment. Implant positioning can be optimized by computer assisted surgery (CAS). Patient specific cutting blocks (PSCB) seem to have the potential to improve component alignment compared to the conventional technique and to be comparable to CAS.Methods.113 knees were selected for PSI and included in this study. Pre- and postoperative mechanical axis, represented by the hip-knee-angle (HKA), the proximal tibial angle (PTA), the distal femoral angle (DFA), and the tibial slope (TS) were measured and the deviation from expected ideal values was calculated.Results.With a margin of error of ±3°, success rates were 81.4% for HKA, 92.0% for TPA, and 94.7% for DFA. With the margin of error for alignments extended to ±4°, we obtained a success rate of 92.9% for the HKA, 98.2% for the PTA, and 99.1% for the DFA. The TS showed postoperative results of 2.86 ± 2.02° (mean change 1.76 ± 2.85°).Conclusion.PSCBs for TKA seem to restore the overall leg alignment. Our data suggest that each individual component can be implanted accurately and the results are comparable to the ones in CAS.

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