The fitting accuracy of pre-bend reconstruction plates and their impact on the temporomandibular joint

Wurm, Matthias C.; Hagen, Julia; Nkenke, Emeka; Neukam, Friedrich Wilhelm; Schlittenbauer, Tilo

doi:10.1016/j.jcms.2018.05.033

Cited by 15 publications

(15 citation statements)

References 29 publications

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“…Furthermore, Zhang et al [ 46 ] found that there was no significant condylar deviation bilaterally in the 3D group, allowing good aesthetic symmetry, although this outcome was not compared to the control group. Wurm et al [ 53 ] also found significantly better plate fitting accuracy in the 3D group ( p < 0.048), allowing for better mandibular contour.…”

Section: Resultsmentioning

confidence: 95%

“…Six research teams refer to measurements taken postoperatively, with a trend to favour the use of CAM/CAD techniques. Lower differences in the bilateral condylar positions were found in the 3D group [ 52 , 53 ], showing that 3D techniques allow better condylar symmetry. Yang et al [ 51 ] found that 3D printed patient-specific plates significantly increased the accuracy of the reconstruction as the deviation of the bilateral mandibular angle was significantly lower than that of the group treated conventionally ( p < 0.005).…”

Section: Resultsmentioning

confidence: 99%

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Comparing the use of conventional and three-dimensional printing (3DP) in mandibular reconstruction

Truscott¹,

Zamani²,

Akrami

2022

BioMed Eng OnLine

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Background There are a number of clinical disorders that require mandibular reconstruction (MR). Novel three-dimensional (3D) printing technology enables reconstructions to be more accurate and beneficial to the patient. However, there is currently no evidence identifying which techniques are better suited for MR, based on the type of clinical disorder the patient has. In this study, we aim to compare 3D techniques with conventional techniques to identify how best to reconstruct the mandible based on the clinical cause that necessitates the reconstructive procedure: cancerous or benign tumours, clinical disorders, infection or disease and trauma or injury. Methods PubMed, Scopus, Embase and Medline were searched to identify relevant papers that outline the clinical differences between 3D and conventional techniques in MR. Data were evaluated to provide a clear outline of suitable techniques for surgery. Results 20 of 2749 papers met inclusion criteria. These papers were grouped based on the clinical causes that required MR into four categories: malignant or benign tumour resection; mandibular trauma/injury and other clinical disorders. Conclusions The majority of researchers favoured 3D techniques in MR. However, due to a lack of standardised reporting in these studies it was not possible to determine which specific techniques were better for which clinical presentations.

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Section: Resultsmentioning

confidence: 95%

Section: Resultsmentioning

confidence: 99%

Comparing the use of conventional and three-dimensional printing (3DP) in mandibular reconstruction

Truscott¹,

Zamani²,

Akrami

2022

BioMed Eng OnLine

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“…Further, the plate design with a suggested retrognathic position and a counterbored plate position on the remaining mandible might release some of the soft tissue tension over the reconstruction plate and reduce the dead space below the plate [33]. Pre-bending the plate reduces operation time and increases the accuracy of the reconstructive result, as shown by others [37,38]. Despite following all these known and described suggestions, both plate groups (pre-bend plate and intraoperatively bend plate) had high rates of complications, with the lower incidence in the pre-bend plate subgroup.…”

Section: Impact Of the Choice Of Reconstructive Technique On The Occumentioning

confidence: 96%

Retrospective analysis of complications in 190 mandibular resections and simultaneous reconstructions with free fibula flap, iliac crest flap or reconstruction plate: a comparative single centre study

et al. 2020

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Objectives The purpose of this study was to evaluate the incidence of complications following mandibular reconstruction and to analyse possible contributing factors. Materials and methods Clinical data and computed tomography scans of all patients who needed a mandibular reconstruction with a reconstruction plate, free fibula flap (FFF) or iliac crest (DCIA) flap between August 2010 and August 2015 were retrospectively analysed. Results One hundred and ninety patients were enrolled, encompassing 77 reconstructions with reconstruction plate, 89 reconstructions with FFF and 24 reconstructions with DCIA flaps. Cutaneous perforation was most frequently detected in the plate subgroup within the early interval and overall (each p = 0.004). Low body mass index (BMI) and total radiation dosage were the most relevant risk factors for the development of analysed complications. Conclusions Microvascular bone flaps have overall less skin perforation than reconstruction plates. BMI and expected total radiation dosage have to be respected in choice of reconstructive technique. Clinical relevance A treatment algorithm for mandibular reconstructions on the basis of our results is presented.

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“…Moreover, this technology has provided more precise and reliable reconstruction with shorter operating time and less extensive surgical exposure. 6,7 The traditional approach to sizeable ameloblastoma is through a large extraoral incision because it provides adequate access for tumor resection and direct approach to the proximal and distal segments of the resected mandible, facilitating plate adaptation and fixation. However, this approach results in unsatisfactory cosmetic outcomes.…”

Section: Introductionmentioning

confidence: 99%

“…This incision avoids facial scars, preserves the perioral musculature, and does not jeopardize the integrity of the facial nerve, providing optimal esthetic and functional results. 8 Several studies 4,7,[9][10][11][12] concerning mandibular reconstruction were focused on the assessment of the 3D accuracy of reconstruction with the pre-bent reconstruction plates. Until now, there is no study explored the effect of the surgical approach to ameloblastoma on the 3D position of the proximal segment after mandibular resection and reconstruction with a pre-bent reconstruction plate.…”

Section: Introductionmentioning

confidence: 99%

Three dimensional accuracy of mandibular reconstruction by pre-bent reconstruction plate using intra oral versus extra oral approaches following mandibular resection in patients with extensive ameloblastoma

Mohamed

2020

Egyptian Dental Journal

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Purpose: This prospective study aimed to compare the intraoral placement of the pre-bent reconstruction plate with that inserted via the extraoral approach, to evaluate their impact on the three-dimensional (3D) position of the proximal segment, after continuity resection of mandibular ameloblastoma.Patients and methods: Patients were divided into two equal groups. In group 1, the mandible was reconstructed with a pre-bent reconstruction plate via an intraoral approach. In group 2, an extraoral approach was used. The primary outcome variables were the need for intraoperative plate readjustment, the time needed for plate insertion, total operation time, difficulties encountered during surgery, and the postoperative stability of the proximal segment. Distances between corresponding anatomical landmarks on the mandibular angle and condyle (A-A`, B-B`, C-C`, B-C`) as well as the intercondylar angle (ICA) and B`XC angle, were measured. The difference between the pre-and postoperative measurements was used to evaluate the reconstruction accuracy. The results of the two groups were compared and analyzed by t-test.Results: Thirty patients were enrolled in this study. In group 1, four plates required minor readjustment. In group 2, only two cases required re-adaptation. The mean time for plate placement was 38 ± 5.8 and 27.5 ± 7.5 minutes in groups 1 and 2, respectively (p = 0.0001). The intraoral insertion of the pre-bent plates revealed a decrease in the linear measurements, resulting in mandibular compression. On contrary, the extraoral approach showed increase in the measurements, resulting in widening of the mandible. However, this width difference was statistically insignificant. Concerning the ICA and B`XC angle, no significant difference could be ascertained between the two groups. Conclusion:Intraoral approach is more conservative procedure, thereby achieving the best esthetic outcomes and resulting in a more accurate 3D mandibular reconstruction. This approach is considered the treatment of choice for resection and reconstruction of mandibular ameloblastoma. However, if the reconstruction plate cannot be inserted intraorally, then extraoral approach is advised.

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The fitting accuracy of pre-bend reconstruction plates and their impact on the temporomandibular joint

Cited by 15 publications

References 29 publications

Comparing the use of conventional and three-dimensional printing (3DP) in mandibular reconstruction

Comparing the use of conventional and three-dimensional printing (3DP) in mandibular reconstruction

Retrospective analysis of complications in 190 mandibular resections and simultaneous reconstructions with free fibula flap, iliac crest flap or reconstruction plate: a comparative single centre study

Three dimensional accuracy of mandibular reconstruction by pre-bent reconstruction plate using intra oral versus extra oral approaches following mandibular resection in patients with extensive ameloblastoma

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