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International Journal of Computer Assisted Radiology and Surgery

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01-12-2015 | Original Article

Multicenter study on the use of patient-specific CAD/CAM reconstruction plates for mandibular reconstruction

Authors: Frank Wilde, Henning Hanken, Florian Probst, Alexander Schramm, Max Heiland, Carl-Peter Cornelius

Published in: International Journal of Computer Assisted Radiology and Surgery | Issue 12/2015

Abstract

Purpose

For the new generation of mandibular reconstruction, patient-specific mandible reconstruction plates (PSMPs) have been developed which are milled from titanium after preoperative computer planning using CAD/CAM procedures. Resection margins and plate position are determined by surgical guides. In addition, length and shape of the plate and the number and angulation of the screw holes can be planned.

Methods

30 patients received such PSMP. Indication ranged from stabilization osteosynthesis, single alloplastic stand-alone reconstruction to microvascular reconstructions. Time for planning, fit of surgical guides and plates, pre-/postoperative occlusion, radiological position of the temporo mandibular joint and complications were recorded.

Results

The median time for online planning was 35 min. The results concerning fit and handling of the PSMP and the surgical guides were mainly very positive. In six cases, the plan had to be adapted to the intraoperative clinical needs. The postoperative position of the condyles in the temporo mandibular fossae was regular in 28 cases. The evaluation of the occlusion was not representative due to not clearly identifiable occlusion in 2/3 of the cases. Nevertheless, complications like postoperative extraoral plate exposure, infection, graft and flap necrosis or difficulties to position the guides or the plate during surgery occurred.

Conclusions

Mandibular reconstruction with PSMP offers a broad range of opportunities and benefits compared with standard procedures and can be recommended for all kind of mandibular reconstructions. It is not yet foreseeable whether PSMP will in future become routine clinical practice for mandibular reconstruction or will be confined to selected isolated cases.

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Title: Multicenter study on the use of patient-specific CAD/CAM reconstruction plates for mandibular reconstruction
Authors: Frank Wilde
Henning Hanken
Florian Probst
Alexander Schramm
Max Heiland
Carl-Peter Cornelius
Publication date: 01-12-2015
Publisher: Springer Berlin Heidelberg
Published in: International Journal of Computer Assisted Radiology and Surgery / Issue 12/2015
Print ISSN: 1861-6410
Electronic ISSN: 1861-6429
DOI: https://doi.org/10.1007/s11548-015-1193-2

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Multicenter study on the use of patient-specific CAD/CAM reconstruction plates for mandibular reconstruction

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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