Safety of boneless reconstruction of the mandible with a CAD/CAM designed titanium device: The replica cohort study

Bedogni, Alberto; Bettini, Giordana; Bedogni, Giorgio; Menapace, Giorgia; Sandi, A.; Michelon, Fabio; Carlo, Roberto Di; Franco, Piero; Saia, Giorgia

doi:10.1016/j.oraloncology.2020.105073

Cited by 12 publications

(6 citation statements)

References 32 publications

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“…Autologous bone grafting with non-vascularized or free vascularized bone flaps remains the gold standard in craniomaxillofacial reconstructive surgery [10,12,36]. It is widely used, and free vascularized bone flaps of the scapula, fibula, and iliac crest grafts provide high success rates in the current literature [36,37].…”

Section: Resultsmentioning

confidence: 99%

“…Autologous bone grafting has the best biocompatibility because it possesses osteoconductive, osteoinductive, and osteogenic properties and is therefore considered the gold standard [2,6,[8][9][10][11]. Donor site morbidity, limited availability of suitable donor bone, acceptor site resorption, and longer surgery time are major drawbacks [6,10,11]. Titanium is a popular material owing to its biocompatibility, osseointegration capacity, and strength [5,12].…”

Section: Introductionmentioning

confidence: 99%

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Reconstruction of Craniomaxillofacial Bone Defects with 3D-Printed Bioceramic Implants: Scoping Review and Clinical Case Series

Verbist,

Vandevelde,

Geusens

et al. 2024

JCM

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Reconstruction of craniomaxillofacial bone defects using 3D-printed hydroxyapatite (HA) bioceramic patient-specific implants (PSIs) is a new technique with great potential. This study aimed to investigate the advantages, disadvantages, and clinical outcomes of these implants in craniomaxillofacial surgeries. The PubMed and Embase databases were searched for patients with craniomaxillofacial bone defects treated with bioceramic PSIs. Clinical outcomes such as biocompatibility, biomechanical properties, and aesthetics were evaluated and compared to those of commonly used titanium or poly-ether-ether-ketone (PEEK) implants and autologous bone grafts. Two clinical cases are presented to illustrate the surgical procedure and clinical outcomes of HA bioceramic PSIs. Literature review showed better a biocompatibility of HA PSIs than titanium and PEEK. The initial biomechanical properties were inferior to those of autologous bone grafts, PEEK, and titanium but improved when integrated. Satisfactory aesthetic results were found in our two clinical cases with good stability and absence of bone resorption or infection. Radiological signs of osteogenesis were observed in the two clinical cases six months postoperatively. HA bioceramic PSIs have excellent biocompatible properties and imitate natural bone biomechanically and radiologically. They are a well-suited alternative for conventional biomaterials in the reconstruction of load-sharing bone defects in the craniomaxillofacial region.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Reconstruction of Craniomaxillofacial Bone Defects with 3D-Printed Bioceramic Implants: Scoping Review and Clinical Case Series

Verbist,

Vandevelde,

Geusens

et al. 2024

JCM

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“…These procedures have been confirmed as viable in restoring the morphology and function of the mandibular region [8], also improving the quality of life of the patients [9].…”

Section: Introductionmentioning

confidence: 93%

Mandibular Reconstruction with Bridging Customized Plate after Ablative Surgery for ONJ: A Multi-Centric Case Series

et al. 2021

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Purpose: Computer-aided methods for mandibular reconstruction have improved both functional and morphological results in patients who underwent segmental mandibular resection. The purpose of this study is to evaluate the overlaying of virtual planning in terms of measures of the Computer Assisted Design/Computer Assisted Manufacturing CAD/CAM plate for mandibular reconstruction in patients who are ineligible for the insertion of reconstructing the titanium plate supported by fibular free flap, due to their poor health status, or in the presence of specific contraindications to autologous bone flap harvest. Materials and methods: The retrospective study performed analyzed the results of nine patients. The patients were treated at the Maxillofacial Surgery Unit of Policlinico S. Orsola of Bologna, Italy, and Policlinico San Marco, Catania, Italy, from April 2016 to June 2021. Superimposition between planning and post operative Computed Tomography CT scan was performed to assess the accuracy. Results: All reconstructive procedures were carried out successfully. No microsurgery-related complications occurred. In two cases, we had plate misplacement, and in one case, plate exposure that led to plate removal. The average accuracy of the series assessed after CT superimposition, as previously described, was 0.95 mm. Conclusions: Considering that microvascular bone transfer is a high-risk procedure in BRONJ patients, we can conclude that the positioning of a customized bridging mandibular prosthesis (CBMP), whether or not it is associated with a microvascular soft tissue transfer, is a safe technique in terms of surgical outcome and feasibility.

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“…21 They have been shown to have acceptable outcomes and long-term complication rates. 22 Potential problems include infection, exposure, and implant fatigue.…”

Section: Other Applications Of Computer-aided Design/computer-aided M...mentioning

confidence: 99%

Computer-Assisted Surgery in Mandible Reconstruction

Shahzad

2024

Semin Plast Surg

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Computer-assisted surgery is the most significant recent advancement in osseous head and neck reconstruction. Computer-aided design (CAD) software allows computerized planning of resection and reconstruction. Computer-aided manufacturing (CAM) can be used to create models, cutting guides, and patient-specific plates. Several studies have shown that these techniques are more accurate and result in decreased flap ischemia times compared with conventional techniques. CAD also facilitates the immediate placement of dental implants. The most useful application of computer-assisted surgery is delayed reconstruction, in which soft tissue contraction and the absence of a specimen as a reference make accurate estimation of the defect challenging. The drawbacks of CAD/CAM are lack of intraoperative flexibility and cost. Some centers have created in-house CAD/CAM processes using open-source software and commercially available three-dimensional printers.

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Safety of boneless reconstruction of the mandible with a CAD/CAM designed titanium device: The replica cohort study

Cited by 12 publications

References 32 publications

Reconstruction of Craniomaxillofacial Bone Defects with 3D-Printed Bioceramic Implants: Scoping Review and Clinical Case Series

Reconstruction of Craniomaxillofacial Bone Defects with 3D-Printed Bioceramic Implants: Scoping Review and Clinical Case Series

Mandibular Reconstruction with Bridging Customized Plate after Ablative Surgery for ONJ: A Multi-Centric Case Series

Computer-Assisted Surgery in Mandible Reconstruction

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