Rutger H Schepers1, Joep Kraeima2, Arjan Vissink2, Lars U Lahoda3, Jan L N Roodenburg2, Harry Reintsema2, Gerry M Raghoebar2, Max J Witjes2. 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. 3. Department of Plastic Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Abstract
BACKGROUND: We compared the pre-operative 3D-surgical plan with the surgical outcome of complex two-stage secondary reconstruction of maxillofacial defects using inserted implants in the prefabricated fibula graft. METHODS: Eleven reconstructions of maxillofacial defects with prefabricated fibulas were performed using a 3D virtual planning. Accuracy of placement of the fibula grafts and dental implants was compared to pre-operative 3D virtual plans by superimposing pre-operative and post-operative CT-scans: we first superimposed the CT-scans on the antagonist jaw, to represent the outcome of occlusion, and then superimposed on the planned fibula segments. RESULTS: Superimposing the CT scans on the antagonist jaws revealed a median deviation of the fibula segments and implants of 4.7 mm (IQR:3-6.5 mm) and 5.5 mm (IQR:2.8-7 mm) from the planned position, respectively. Superimposing of the CT scans on the fibula segments revealed a median difference of fibula and implant placement of 0.3 mm (IQR:0-1.6 mm) and 2.2 mm (IQR:1.5-2.9 mm), respectively. CONCLUSIONS: The final position of the fibula graft is determined by the occlusion of the denture, which is designed from the 3D plan. From a prosthodontic perspective, the accuracy of 3D-surgical planning of reconstruction of maxillofacial defects with a fibula graft and the implants allows for a favorable functional position of the implants and fibula graft.
BACKGROUND: We compared the pre-operative 3D-surgical plan with the surgical outcome of complex two-stage secondary reconstruction of maxillofacial defects using inserted implants in the prefabricated fibula graft. METHODS: Eleven reconstructions of maxillofacial defects with prefabricated fibulas were performed using a 3D virtual planning. Accuracy of placement of the fibula grafts and dental implants was compared to pre-operative 3D virtual plans by superimposing pre-operative and post-operative CT-scans: we first superimposed the CT-scans on the antagonist jaw, to represent the outcome of occlusion, and then superimposed on the planned fibula segments. RESULTS: Superimposing the CT scans on the antagonist jaws revealed a median deviation of the fibula segments and implants of 4.7 mm (IQR:3-6.5 mm) and 5.5 mm (IQR:2.8-7 mm) from the planned position, respectively. Superimposing of the CT scans on the fibula segments revealed a median difference of fibula and implant placement of 0.3 mm (IQR:0-1.6 mm) and 2.2 mm (IQR:1.5-2.9 mm), respectively. CONCLUSIONS: The final position of the fibula graft is determined by the occlusion of the denture, which is designed from the 3D plan. From a prosthodontic perspective, the accuracy of 3D-surgical planning of reconstruction of maxillofacial defects with a fibula graft and the implants allows for a favorable functional position of the implants and fibula graft.
Authors: N Assink; J Kraeima; C H Slump; K Ten Duis; J P P M de Vries; A M L Meesters; P van Ooijen; M J H Witjes; F F A IJpma Journal: Sci Rep Date: 2019-10-07 Impact factor: 4.379
Authors: Lidia S van Huizen; Pieter U Dijkstra; Bernard F A M van der Laan; Harry Reintsema; Kees T B Ahaus; Hendrik P Bijl; Jan L N Roodenburg Journal: BMC Health Serv Res Date: 2018-10-29 Impact factor: 2.655
Authors: Gustaaf J C van Baar; Kitty Schipper; Tymour Forouzanfar; Lars Leeuwrik; Henri A H Winters; Angela Ridwan-Pramana; Frank K J Leusink Journal: J Clin Med Date: 2021-03-16 Impact factor: 4.241