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This paper describes a new protocol for mandibular reconstruction. Computer-aided design/computer-aided manufacturing (CAD/CAM) technology was used to manufacture custom-made cutting guides for tumor ablation and reconstructive plates to support fibula free flaps. CT scan data from a patient with an odontogenic keratocyst on the left mandibular ramus were elaborated to produce a virtual surgical plan of mandibular osteotomy in safe tissue for complete ramus resection. The CAD/CAM procedure was used to construct a customized surgical device composed of a cutting guide and a titanium reconstructive bone plate. The cutting guide allowed the surgeon to precisely transfer the virtual planned osteotomy into the surgical environment. The bone plate, including a custom-made anatomical condylar prosthesis, was designed using the outer surface of the healthy side of the mandible to obtain an ideal contour and avoid the bone deformities present on the side affected by the tumor. Operation time was reduced in the demolition and reconstruction phases. Functional and aesthetic outcomes allowed patients to immediately recover their usual appearance and functionality. This new protocol for mandibular reconstruction using CAD/CAM to construct custom-made guides and plates may represent a viable way to reproduce the patient's anatomical contour, give the surgeon better procedural control, and reduce operation time.

If you would like to write for this, or any other Emerald publication, then please use our Emerald for Authors service information about how to choose which publication to write for and submission guidelines are available for all. Please visit www.emeraldinsight.com/authors for more information. About Emerald www.emeraldinsight.comEmerald is a global publisher linking research and practice to the benefit of society. The company manages a portfolio of more than 290 journals and over 2,350 books and book series volumes, as well as providing an extensive range of online products and additional customer resources and services.Emerald is both COUNTER 4 and TRANSFER compliant. The organization is a partner of the Committee on Publication Ethics (COPE) and also works with Portico and the LOCKSS initiative for digital archive preservation. AbstractPurpose -The purpose of this paper is to describe the method of virtually and physically reconstructing the missing part of a badly damaged medieval skull by means of reverse engineering, computer-aided design (CAD) and rapid prototyping (RP) techniques. Design/methodology/approach -Laser scanning data were used to create the 3D model of the damaged skull. Starting from this digital model, a virtual reconstruction of the missing part of the skull, based on the ideal symmetry with respect to the mid-sagittal plane, was achieved in a CAD environment. Finally, the custom-designed model was directly fabricated by means of the RP process. Findings -The result shows that the designed missing part of the skull fits very well with the existing skeletal remains. The final physical assembly of the prototyped element on the damaged skull was tested, restoring it to its whole original shape.Research limitations/implications -The entire process was time-consuming and may be applied just to the most representative skeletal remains. Practical implications -The method allows accurate fabrication of the missing part of the skull to be joined with the original skeletal remains. The advantage of using this technique is that the joining operation can be carried out without any need of supplementary connecting material, such as glue or plaster, to fix together the two parts. Originality/value -The reversible and non-invasive method improves the restoration process, reduces the risk of damage to the skeletal structure and allows reversion to the original repair as it was before.

Abstract-A new protocol for making an immediate provisional eyeglasses-supported nasal prosthesis is presented that uses laser scanning, computer-aided design/computer-aided manufacturing procedures, and rapid prototyping techniques, reducing time and costs while increasing the quality of the final product. With this protocol, the eyeglasses were digitized, and the relative position of the nasal prosthesis was planned and evaluated in a virtual environment without any try-in appointment. This innovative method saves time, reduces costs, and restores the patient's aesthetic appearance after a disfiguration caused by ablation of the nasal pyramid better than conventional restoration methods. Moreover, the digital model of the designed nasal epithesis can be used to develop a definitive prosthesis anchored to osseointegrated craniofacial implants.