Tags

Type your tag names separated by a space and hit enter

Accurate reconstruction of discontinuous mandible using a reverse engineering/computer-aided design/rapid prototyping technique: a preliminary clinical study.
J Oral Maxillofac Surg. 2010 Sep; 68(9):2115-21.JO

Abstract

PURPOSE

To improve the reconstructive surgical outcome of a discontinuous mandibular defect, we used reverse engineering (RE), computer-aided design (CAD), and rapid prototyping (RP) technique to fabricate customized mandibular trays to precisely restore the mandibular defects. Autogenous bone grafting was also used to restore the bony continuity for occlusion rehabilitation.

PATIENTS AND METHODS

Six patients who had undergone block resection of the mandible underwent reconstruction using a custom titanium tray combining autogenous iliac grafts. The custom titanium tray was made using a RE/CAD/RP technique. A virtual 3-dimensional model was obtained by spiral computed tomography scanning. The opposite side of the mandible was mirrored to cover the defect area to restore excellent facial symmetry. A bone grafting tray was designed from the mirrored image and manufactured using RP processing and casting. The mandibular defects were restored using the trays in combination of autologous iliac grafting. An implant denture was made for 1 of the 6 patients at 24 weeks postoperatively for occlusion rehabilitation.

RESULTS

The trays fabricated using this technique fit well in all 6 patients. The reconstructive procedures were easy and time saving. Satisfactory facial symmetry was restored. No severe complications occurred in the 5 patients without occlusion rehabilitation during a mean 50-month follow-up period. The reconstruction in the patient with occlusion lasted for only 1 year and failed eventually because of bone resorption and infection.

CONCLUSIONS

Mandibular reconstruction was facilitated using the RE/CAD/RP technique. Satisfactory esthetic results were achieved. However, the rigidity of the cast tray could cause severe stress shielding to the grafts, which could lead to disuse atrophy. Therefore, some modification is needed for functional reconstruction.

Links

Publisher Full Text
Aggregator Full Text

Authors+Show Affiliations

Zhou LB
Department of Oral and Maxillofacial Surgery, School of Stomatology, Fourth Military Medical University, Shaanxi, People's Republic of China.
Shang HT
No affiliation info available
He LS
No affiliation info available
Bo B
No affiliation info available
Liu GC
No affiliation info available
Liu YP
No affiliation info available
Zhao JL
No affiliation info available

MeSH

AdultBone TransplantationComputer-Aided DesignDental Prosthesis, Implant-SupportedDental Stress AnalysisDenture, Partial, RemovableFemaleHumansMaleMandibleMandibular DiseasesMandibular NeoplasmsMandibular ProsthesisMandibular Prosthesis ImplantationModels, AnatomicOral Surgical ProceduresProsthesis DesignReconstructive Surgical ProceduresSurgery, Computer-AssistedTitaniumTomography, Spiral ComputedYoung Adult

Pub Type(s)

Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20542365

Citation

Zhou, Li-bin, et al. "Accurate Reconstruction of Discontinuous Mandible Using a Reverse Engineering/computer-aided Design/rapid Prototyping Technique: a Preliminary Clinical Study." Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons, vol. 68, no. 9, 2010, pp. 2115-21.
Zhou LB, Shang HT, He LS, et al. Accurate reconstruction of discontinuous mandible using a reverse engineering/computer-aided design/rapid prototyping technique: a preliminary clinical study. J Oral Maxillofac Surg. 2010;68(9):2115-21.
Zhou, L. B., Shang, H. T., He, L. S., Bo, B., Liu, G. C., Liu, Y. P., & Zhao, J. L. (2010). Accurate reconstruction of discontinuous mandible using a reverse engineering/computer-aided design/rapid prototyping technique: a preliminary clinical study. Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons, 68(9), 2115-21. https://doi.org/10.1016/j.joms.2009.09.033
Zhou LB, et al. Accurate Reconstruction of Discontinuous Mandible Using a Reverse Engineering/computer-aided Design/rapid Prototyping Technique: a Preliminary Clinical Study. J Oral Maxillofac Surg. 2010;68(9):2115-21. PubMed PMID: 20542365.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Accurate reconstruction of discontinuous mandible using a reverse engineering/computer-aided design/rapid prototyping technique: a preliminary clinical study. AU - Zhou,Li-bin, AU - Shang,Hong-tao, AU - He,Li-sheng, AU - Bo,Bin, AU - Liu,Gui-cai, AU - Liu,Yan-pu, AU - Zhao,Jin-long, Y1 - 2010/06/12/ PY - 2009/02/08/received PY - 2009/06/04/revised PY - 2009/09/14/accepted PY - 2010/6/15/entrez PY - 2010/6/15/pubmed PY - 2010/9/17/medline SP - 2115 EP - 21 JF - Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons JO - J Oral Maxillofac Surg VL - 68 IS - 9 N2 - PURPOSE: To improve the reconstructive surgical outcome of a discontinuous mandibular defect, we used reverse engineering (RE), computer-aided design (CAD), and rapid prototyping (RP) technique to fabricate customized mandibular trays to precisely restore the mandibular defects. Autogenous bone grafting was also used to restore the bony continuity for occlusion rehabilitation. PATIENTS AND METHODS: Six patients who had undergone block resection of the mandible underwent reconstruction using a custom titanium tray combining autogenous iliac grafts. The custom titanium tray was made using a RE/CAD/RP technique. A virtual 3-dimensional model was obtained by spiral computed tomography scanning. The opposite side of the mandible was mirrored to cover the defect area to restore excellent facial symmetry. A bone grafting tray was designed from the mirrored image and manufactured using RP processing and casting. The mandibular defects were restored using the trays in combination of autologous iliac grafting. An implant denture was made for 1 of the 6 patients at 24 weeks postoperatively for occlusion rehabilitation. RESULTS: The trays fabricated using this technique fit well in all 6 patients. The reconstructive procedures were easy and time saving. Satisfactory facial symmetry was restored. No severe complications occurred in the 5 patients without occlusion rehabilitation during a mean 50-month follow-up period. The reconstruction in the patient with occlusion lasted for only 1 year and failed eventually because of bone resorption and infection. CONCLUSIONS: Mandibular reconstruction was facilitated using the RE/CAD/RP technique. Satisfactory esthetic results were achieved. However, the rigidity of the cast tray could cause severe stress shielding to the grafts, which could lead to disuse atrophy. Therefore, some modification is needed for functional reconstruction. SN - 1531-5053 UR - https://www.unboundmedicine.com/medline/citation/20542365/Accurate_reconstruction_of_discontinuous_mandible_using_a_reverse_engineering/computer_aided_design/rapid_prototyping_technique:_a_preliminary_clinical_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0278-2391(09)01737-6 DB - PRIME DP - Unbound Medicine ER -