CAD/CAM guided secondary mandibular reconstruction of a discontinuity defect after ablative cancer surgery

The key to accuracy of zygoma repositioning: Suitability of the SynpliciTi customized guide-plates

“…More or less similar processes have been reported in orthognathic procedures, using pre-drilling and/or positioning guides or pre-bent standard plates (Bai et al, 2012(Bai et al, , 2010Olszewski et al, 2010;Polley and Figueroa, 2013). Custom made titanium implants have sometimes been reported (Ciocca et al, 2012;Derand et al, 2012;Philippe, 2013;Zhou et al, 2010). The assets of M A N U S C R I P T…”

Computer-Assisted Surgery for Segmental Mandibular Reconstruction with the Osteoseptocutaneous Fibula Flap

“…[1][2][3][4][5][7][8][9][10][11][12][13][14][15] Benefits of using the new technology could be improved surgical precision; decreased operative time, cost, and complications; and enhanced outcomes, with a gentle learning curve. 6,8,10,11,[16][17][18] For segmental mandibular reconstruction, the unique and three-dimensional parabolic shape of the mandible is difficult to construct from a flat, short bone such as the fibula, 19,20 the workhorse vascularized bone graft at the present time. 21,22 Therefore, a strong rationale for computer-aided surgery with the perceived advantages of improved aesthetics and better interarch relationship between the maxilla and the mandible Disclosure: The authors have no conflicts of interest to declare.…”

“…1,6,7,10,13 Unlike the traditional method or the free-hand technique, which relies on two-dimensional models, computer-aided reconstruction uses virtual three-dimensional models for simulation surgery, which is theoretically more capable of transferring the plan from the virtual mode into the clinical one, resulting in seamless, symmetrical osseous reconstruction. 5,15,16,18,20,21 However, in oncologic reconstruction and in some maxillofacial trauma, for example, recipient vessels and pedicle reach, oral lining and skin deficiency, and the equivalent osseous defect (isolated, compound, composite, and extensive composite mandibular defects), volume restoration/ augmentation and adjunct trismus release (bony and soft tissue release), location and type of the skin vessels supplying the osteoseptocutaneous fibula flap skin paddle, and the vascular pedicle of the soleus muscle are important for the success of segmental mandibular reconstruction. [23][24][25][26][27] However, these factors appear to be omitted in both the virtual and surgical phases of computer-aided reconstruction.…”

Three-Dimensional Virtual Surgery Accuracy for Free Fibula Mandibular Reconstruction: Planned Versus Actual Results

“…[7][8][9][10][11][12][13] Digitized simulation of the bony resection and reconstruction is possible and transferrable to intraoperative templates and guides. True-to-size stereolithographic models also can be generated to allow for pre-bending of osteosynthesis plates.…”