Improving Aesthetic Outcome in Managing Acute and Chronic Upper and Midface Deformities Using Computer Assisted Planning

Abstract

Surgical procedures in the facial region are associated by a variety of difficulties. The anatomy of the maxillofacial region, the complexity of the bony architecture as well as the esthetic implications. The three dimensional imaging and 3D printing, have been applied for the restoration the complex anatomy of craniofacial structures. In addition, mirror-imaging techniques advocating 3D computed tomographic (CT) scanning and 3D printing can maximize the surgical outcome on both the functional and esthetic reconstruction levels. A synthetic scaffold can be pre-molded to the individual prototype skull model to resemble the anatomic contour before applying it to cover the orbital defects. Our aim is to show the importance and present our experience with three-dimensional virtual planning in solving a variety of acute and chronic clinical deformities within the scope of trauma in the cranio maxillofacial region. 25 patients were retrospectively recruited. Mean age was 33.5 years (range 13-59), male: female ratio = 2.6:1 (18:7). Eleven patients had acute injuries (44%) while the remaining 14 patients (56%) had chronic (malunited) fractures performed in 2 different centers treating maxillofacial deformities operated utilizing 3D planning protocols. The advocation of the virtual planning techniques, three dimension printing and printed custom implant enabled an accurate reduction and fixation procedure of complex acute and chronic complex upper and midface fracture, which is reflected in very satisfactory aesthetic outcome.