Stereoscopic lithography: customized titanium implants in orofacial reconstruction. A new surgical technique without flap cover.

Head and neck surgery may involve complex methods of composite reconstruction that do not replicate the volume and contour of the normal anatomy. 'Functional' reconstruction implies replication of the normal volume and contour of both hard and soft tissues to produce normal form and function of the face, mouth and jaws. Techniques such as stereoscopic lithography and computer-assisted design, and-manufacture (CAD-CAM) have been successfully used with computer-numerized control (CNC) milling to manufacture customized titanium implants for single-stage reconstruction of the maxilla, hemimandible and dentition without the use of composite flap cover after the removal of tumours. Reduction in theatre time and personnel, less need for intensive care, and earlier discharge from hospital, indicate possible savings of Pound Sterling 17,000-Pound Sterling 19,000 per patient. There are implications for surgery in general, and further research and development is advocated.