Use of Dental Impression Silicone to Fabricate Simple Surgical Guides in Mandibular Reconstruction∗

Abstract

Background: Several recent reports have described the development and use of three-dimensional (3D) printed surgical osteotomy guides. However, these methods: are usually costly. Here, we introduce a novel method of manufacturing surgical guides built from inexpensive, easy-to-use, and sterilizable dental impression silicone. Methods: Mandibular and fibular models were prepared using a 3D printer for 10 patients undergoing free fibula flap transfer after mandibular resection. During preoperative simulation surgery, Protesil labor, a dental silicone, was molded to the same size as the fibular models to act as surgical guides. Results: The authors compared pre-and post-operative bone angles and bone lengths for all cases using simulation surgery models and postoperative 3D computed tomography. Mean bone angle difference was 2.68 and mean bone length difference was 1.7 mm. Cost of the dental silicone was approximately US$5/patient. Conclusions:In our series this method allowed the surgeon to perform an accurate osteotomy, inexpensively and time-efficiently.

Dental Silicone-based Surgical Guides to Harvest the Chimeric Scapular Flap: Preventing Iatrogenic Vascular Injury

“…Although virtual surgical planning (VSP) has been previously described for free fibula-based mandibular reconstructions, 7 the current evidence on this matter for scapular flaps is limited. 1 , 5 The authors here propose a novel, inexpensive autoclavable surgical guide to harvest a chimeric scapular flap based on the thoracodorsal vessels supercharged with the CSA.…”

“…2,8 Nonetheless, the selection of the osteotomy site can be difficult due to the unfamiliarity with the subscapular system and variability in shape and thickness of the scapular three-dimensional configuration. 1,9 Although virtual surgical planning (VSP) has been previously described for free fibula-based mandibular reconstructions, 7 the current evidence on this matter for scapular flaps is limited. 1,5 The authors here propose a novel, inexpensive autoclavable surgical guide to harvest a chimeric scapular flap based on the thoracodorsal vessels supercharged with the CSA.…”

“…The scapular models were prepared using a 3D printer (3D Systems ProJet 460 plus; RICOH Co, Ltd., Tokyo, Japan) and a specialized software (Mimics, Materialise NV, Belgium). 7 Drill markings of the perforating angular and periosteal branches were added to the models with guidance of life-sized printouts of 3D computed tomography angiography images of the subscapular artery. A simulation osteotomy was carried out on the model (Fig.…”