Rutger H Schepers1, Gerry M Raghoebar2, Arjan Vissink3, Martin W Stenekes4, Joep Kraeima5, Jan L Roodenburg6, Harry Reintsema7, Max J Witjes8. 1. Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. Electronic address: r.h.schepers@umcg.nl. 2. Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. Electronic address: g.m.raghoebar@umcg.nl. 3. Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. Electronic address: a.vissink@umcg.nl. 4. Department of Plastic Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. Electronic address: m.w.stenekes@umcg.nl. 5. Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands; MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, The Netherlands. Electronic address: j.kraeima@umcg.nl. 6. Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. Electronic address: j.l.n.roodenburg@umcg.nl. 7. Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. Electronic address: h.reintsema@umcg.nl. 8. Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. Electronic address: m.j.h.witjes@umcg.nl.
Abstract
BACKGROUND: The purpose of this study was to analyze the accuracy of mandibular reconstruction using patient-specific computer-aided designed and computer-aided manufactured (CAD/CAM) reconstruction plates as a guide to place fibula grafts and dental implants in a one-stage procedure using pre-operative 3D virtual planning. METHODS: Seven consecutive patients were analyzed retrospectively, the 3D accuracy of placement of the fibula grafts and dental implants was compared to the virtual plan. RESULTS: Six out of seven flaps survived for an average follow-up time of 9.4 months. The outcome was compared to the virtual plan, superimposed on the mandible. For the fibula segments, the mean deviation (SD) was 3.0 (1.8) mm and the mean angulation (SD) was 4.2° (3.2°). For the implants, the mean deviation (SD) was 3.3 (1.3) mm and the mean angulation (SD) was 13.0° (6.7°). The mean (SD) mandibular resection plane deviation was 1.8 (0.9) mm. CONCLUSIONS: A patient-specific reconstruction plate is a valuable tool in the reconstruction of mandibular defects with fibula grafts and dental implants. Implant angulation showed a greater deviation from the virtual plans in patients with a sharp ventral fibula rim, where the guide is removed after pilot drilling of the implants.
BACKGROUND: The purpose of this study was to analyze the accuracy of mandibular reconstruction using patient-specific computer-aided designed and computer-aided manufactured (CAD/CAM) reconstruction plates as a guide to place fibula grafts and dental implants in a one-stage procedure using pre-operative 3D virtual planning. METHODS: Seven consecutive patients were analyzed retrospectively, the 3D accuracy of placement of the fibula grafts and dental implants was compared to the virtual plan. RESULTS: Six out of seven flaps survived for an average follow-up time of 9.4 months. The outcome was compared to the virtual plan, superimposed on the mandible. For the fibula segments, the mean deviation (SD) was 3.0 (1.8) mm and the mean angulation (SD) was 4.2° (3.2°). For the implants, the mean deviation (SD) was 3.3 (1.3) mm and the mean angulation (SD) was 13.0° (6.7°). The mean (SD) mandibular resection plane deviation was 1.8 (0.9) mm. CONCLUSIONS: A patient-specific reconstruction plate is a valuable tool in the reconstruction of mandibular defects with fibula grafts and dental implants. Implant angulation showed a greater deviation from the virtual plans in patients with a sharp ventral fibula rim, where the guide is removed after pilot drilling of the implants.
Authors: Astrid M Hoving; Joep Kraeima; Rutger H Schepers; Hildebrand Dijkstra; Jan Hendrik Potze; Bart Dorgelo; Max J H Witjes Journal: PLoS One Date: 2018-04-20 Impact factor: 3.240
Authors: P Canzi; M Magnetto; S Marconi; P Morbini; S Mauramati; F Aprile; I Avato; F Auricchio; M Benazzo Journal: Acta Otorhinolaryngol Ital Date: 2018-08 Impact factor: 2.124
Authors: A N Zeller; M T Neuhaus; L V M Weissbach; M Rana; A Dhawan; F M Eckstein; N C Gellrich; R M Zimmerer Journal: J Maxillofac Oral Surg Date: 2020-01-03