Occlusal‐based planning for dental rehabilitation following segmental resection of the mandible and maxilla

Leinkram, David; Wykes, James; Deshpande, Suhas; McLaughlin, Margaret; Garg, Prachi; Wallace, Christine; Howes, Dale; Clark, Jonathan

doi:10.1111/ans.16441

Cited by 17 publications

(16 citation statements)

References 6 publications

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“…Over this period, we also noted an increase in T4 tumours, and alveolar or hard palate tumours referred to our centre (Table 1). Whilst there is no evidence of increased incidence in alveolar or hard palate malignancies globally [30], our unit has a special interest in mandibular and maxillary reconstruction, with a multidisciplinary team established to provide dental and prosthetic rehabilitation utilising complex 3D modelling [31,32]. This increase likely reflects a referral bias to our unit given this focus of our unit.…”

Section: Discussionmentioning

confidence: 99%

Oral Cavity Reconstruction over a 30-Year Period at a Dedicated Tertiary Head and Neck Cancer Centre

et al. 2022

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There are around 2,500 new cases of oral cavity squamous cell carcinoma (OSCC) reported yearly within Australia. Resection often leads to substantial defects, requiring complex reconstruction. The aim of this study was to examine how reconstruction at a dedicated head and neck cancer unit has evolved over a 30-year period. A retrospective review was conducted of all OSCC carcinoma cases performed from 1988 to 2017. Data was analysed in six-time periods; pre-1995, 1995–1999, 2000–2004, 2005–2009, 2010–2014, and 2015 and above. A total of 903 patients were identified, of which 56.1% (n = 507) underwent free flap reconstruction including 426 (84.0%) soft tissue free flaps (STFF) and 81 (16.0%) bony free flaps (BFF). STFF usage remained stable over time. The radial forearm was the most common free flap but declined over time with increasing use of the anterolateral thigh flap. The number of BFF increased from 5.0% before 1995 to 20.4% in 1995–2015. The tongue was the most common subsite, followed by the floor of mouth. Free flaps were utilised in more than 50% of OSCC reconstructions at each time period. Over time, the proportion of different STFF evolved towards increased use of the ALT flap and BFF within our institution. Level of evidence: Level four.

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Section: Discussionmentioning

confidence: 99%

Oral Cavity Reconstruction over a 30-Year Period at a Dedicated Tertiary Head and Neck Cancer Centre

et al. 2022

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“…The position of the osseointegrated implants is then determined based on the projected occlusion, and the fibula segments are positioned so as to optimally accommodate the position of the implants and ensure adequate bone stock around them. This typically results in the crest of the fibula bone segment being ~15 mm from the occlusal plane posteriorly, and 16 to 17 mm anteriorly, with implants, at least 5 mm from the osteotomies and separated by 3 mm of bone 63. Additional fibula segments and the reconstruction plate can then be placed to assist with reestablishing the bony contour.…”

Section: Discussionmentioning

confidence: 99%

“…Leinkram and colleagues and Seikaly and colleagues have recently published detailed descriptions of their respective techniques for reconstruction using fibula-free flaps with osseointegrated dental implants. In essence, the bony resection is planned based on high-resolution CT scans, and a virtual occlusion is generated across the zone of missing dentition that includes the dental coronal morphology 63,64 (Figs. 2A, B).…”

Section: Mandible and Maxilla Reconstructionmentioning

confidence: 99%

Modeling Methods in Craniofacial Virtual Surgical Planning

Riordan

Yung

Cheng

et al. 2023

Journal of Craniofacial Surgery

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Despite the widespread use of virtual surgical planning (VSP), few papers describe the modeling methods used to generate the digital simulations that underpin VSP. This paper aims to review the modeling methods that are currently available for use in VSP and the implications of their use in clinical practice. A literature review was undertaken of the two broad categories of modeling techniques; contour-based planning-namely mirroring from the contralateral side, templating from a normative database, and extrapolation from surrounding landmarks-and occlusal-based planning (OBP). The indications for each modeling method were discussed, including mandibular/maxillary reconstruction, pediatric craniofacial surgery, and orthognathic, as well as the limitations to the accuracy of modeling types. Unilateral defects of the upper/ midface, wherein contour accuracy is paramount, are best reconstructed using mirroring methods, whereas bilateral defects-or cases with asymmetry due to craniofacial dysmorphology-are most suited to normative-data-based methods. Cases involving resection of the alveolar margin, in which functional occlusion is the primary outcome are best managed with OBP. Similarly, orthognathic surgery typically uses OBP, although complex cases involving asymmetry, such as clefts, may benefit from a combination of OBP and normative data methods. The choice of modeling methods is, therefore, largely driven by the defect type and the goals of reconstruction.

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“…The introduction of virtual or digital surgical planning (DSP) has improved accuracy, reduced surgical times, and allowed for the medium. [1][2][3][4] Digital surgical planning allows for the creation of patient-specific biomodels, guides and fixation plates. 1,3 Virtual reality (VR) is a three-dimensional, stereoscopic, computer-generated environment that, with the use of a headset connected to a computer allows an individual to explore and interact with an environment with six degrees of freedom.…”

Section: Introductionmentioning

confidence: 99%

“…The introduction of virtual or digital surgical planning (DSP) has improved accuracy, reduced surgical times, and allowed for the reconstruction of more complex craniofacial defects 1–3 . It requires the presence of an engineer and surgeon, with a three‐dimensional (3D) planning session performed online with a conventional computer screen displaying 3D information on a two dimensional medium 1–4 . Digital surgical planning allows for the creation of patient‐specific biomodels, guides and fixation plates 1,3 .…”

Section: Introductionmentioning

confidence: 99%

Virtual reality digital surgical planning for jaw reconstruction: a usability study

Manzie

MacDougall

Cheng

et al. 2023

ANZ Journal of Surgery

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Background: Digital surgical planning (DSP) has revolutionized the preparation and execution of the management of complex head and neck pathologies. The addition of virtual reality (VR) allows the surgeon to have a three-dimensional experience with six degrees of freedom for visualizing and manipulating objects. This pilot study describes the participants experience with the first head and neck reconstructive VR-DSP platform. Methods: An original VR-DSP platform has been developed for planning the ablation and reconstruction of head and neck pathologies. A prospective trial utilizing this platform involving reconstructive surgeons was performed. Participants conducted a simulated VR-DSP planning session, pre-and post-questionnaire as well as audio recordings allowing for qualitative analysis. Results: Thirteen consultant reconstructive surgeons representing three surgical backgrounds with varied experience were recruited. The majority of surgeons had no previous experience with VR. Based on the system usability score, the VR-DSP platform was found to have above average usability. The qualitative analysis demonstrated the majority had a positive experience. Participants identified some perceived barriers to implementing the VR-DSP platform. Conclusions: Virtual reality-digital surgical planning is usable and acceptable to reconstructive surgeons. Surgeons were able to perform the steps in an efficient time despite limited experience. The addition of VR offers additional benefits to current VSP platforms. Based on the results of this pilot study, it is likely that VR-DSP will be of benefit to the reconstructive surgeon. reconstruction of more complex craniofacial defects. [1][2][3] It requires the presence of an engineer and surgeon, with a three-dimensional (3D) planning session performed online with a conventional computer screen displaying 3D information on a two dimensional

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Occlusal‐based planning for dental rehabilitation following segmental resection of the mandible and maxilla

Cited by 17 publications

References 6 publications

Oral Cavity Reconstruction over a 30-Year Period at a Dedicated Tertiary Head and Neck Cancer Centre

Oral Cavity Reconstruction over a 30-Year Period at a Dedicated Tertiary Head and Neck Cancer Centre

Modeling Methods in Craniofacial Virtual Surgical Planning

Virtual reality digital surgical planning for jaw reconstruction: a usability study

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