Virtual planning, simultaneous dental implantation and CAD/CAM plate fixation: a paradigm change in maxillofacial reconstruction

Seier, Thomas; Hingsammer, Lukas; Schumann, Paul; Gander, Thomas; Rücker, Martin; Lanzer, Martin

doi:10.1016/j.ijom.2019.11.010

Cited by 14 publications

(17 citation statements)

References 31 publications

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“…This showed that simultaneous dental implant placement in fibula free flap had a high survival rate if the free flap transfer was successful. This is in agreement with other retrospective studies which reported the overall implant survival rate of 95% to 100% with a mean follow‐up ranging from 8 to 71.7 months 6,16‐22 . Noteworthily, five out of 6 studies reporting 100% survival in simultaneous implant placement were for benign disease 6,16‐18,20 .…”

Section: Discussionsupporting

confidence: 90%

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“Three‐in‐one” patient‐specific surgical guides for simultaneous dental implants in fibula flap jaw reconstruction: A prospective case series

Zhu

Pow

et al. 2020

Clin Implant Dent Rel Res

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Background Conventional freehand immediate placement of dental implants is technically challenging in the jaw reconstructive surgery. Computer‐aided surgery might be the best solution, however, there has not been any standard approach to ensure the accuracy and efficiency of simultaneous dental implants in fibula flap jaw reconstruction. Purpose We aim to evaluate the clinical outcome of simultaneous dental implant in fibula flap using the “three‐in‐one” patient‐specific surgical guide (3‐in‐1‐PSSG) in an open‐label, prospective, single‐arm, and single‐center clinical trial. Materials and Methods A novel computer‐aided designed and three‐dimensional (3D) printed 3‐in‐1‐PSSG, which contains functions of fibula segmentation, surgical plate positioning and implant placement, was used to facilitate the reconstructive surgery and simultaneous dental implant placement. The intraoperative success of dental implant placement, implant survival rate and accuracy of dental implant placement were reported. Results From November 2018 to June 2020, 15 consecutive patients with 48 dental implants were enrolled in this study. Fifteen 3‐in‐1‐PSSGs were fabricated with a mean number of dental implants per guide of 3.2 ± 1.5. The intraoperative success rate of this approach was 14 out of 15. With an average follow‐up period of 40 weeks, the overall implant survival rate was 83.3% (40/48). Eight implants were removed due to two fibula flap failures. The mean deviation at the implant platform and implant apex were 2.8 mm (interquartile range [IQR]: 1.9‐3.4) and 3.2 mm (IQR: 2.0‐4.6), and the angular deviation was 2.5° (IQR: 1.1‐6.8). Conclusions Our preliminary data indicated that the 3D printed 3‐in‐1‐PSSG facilitated simultaneous dental implant in fibula flap jaw reconstruction with a favorable intraoperative success and short‐term clinical outcome. It might be a viable alternative to allow one‐step immediate oral rehabilitation in patients underwent jaw reconstruction with free flaps. Long‐term results with a larger sample size are warranted.

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Section: Discussionsupporting

confidence: 90%

“…Noteworthily, five out of 6 studies reporting 100% survival in simultaneous implant placement were for benign disease 6,16‐18,20 . Two other studies reported the reasons for failed dental implants (6/58 and 2/76, respectively) were due to flap failure and local infection 21,22 …”

Section: Discussionmentioning

confidence: 99%

“Three‐in‐one” patient‐specific surgical guides for simultaneous dental implants in fibula flap jaw reconstruction: A prospective case series

Zhu

Pow

et al. 2020

Clin Implant Dent Rel Res

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“…Prosthetic oriented planning is fundamental to achieve successful implant‐prosthetic rehabilitations (Seier et al., 2020) and clinical evaluations at prosthetic level should be documented more often. Especially, prosthetic long‐term data in patients after HNC therapy are scarce.…”

Section: Discussionmentioning

confidence: 99%

Retrospective long‐term clinical evaluation of implant‐prosthetic rehabilitations after head and neck cancer therapy

Pieralli

Spies

Schweppe

et al. 2021

Clinical Oral Implants Res

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Objective To assess clinical and patient‐reported outcomes of implant‐prosthetic rehabilitations in patients with a history of head–neck cancer (HNC), treated with tumor resection without (TR) or with adjuvant radiotherapy (TR/RT). A healthy cohort rehabilitated with the same reconstructive protocols served as control group (C). Materials and Methods A total of 28 women and 29 men were considered in the present retrospective study. Participants received 322 implants, finally supporting 79 prosthetic reconstructions. Primary outcome was the assessment of implant and prosthetic survival rates. Furthermore peri‐implant soft tissue parameters (attached peri‐implant mucosa, AM; modified bleeding and plaque indices, mBI/mPI; probing depth, PD) and prosthetic technical complications were documented. Patient‐reported outcome measures (PROMs) by means of visual analog scales (VAS) and the Oral Health Impact Profile German 14 form (OHIP G14) were collected. For statistical purposes Chi‐square and Mann–Whitney‐U‐Test were adapted. Results After a mean follow‐up of 81.2 ± 50.3 months, implant survival rate was 98.1% (HNC‐TR), 98.2% (HNC‐TR/RT) and 100.0% (C), respectively (four implants failed in the HNC groups). HNC‐TR/RT showed significant higher mPI and mBI compared to C. Within HNC‐TR/RT, vestibuloplasty significantly reduced mBI and PD values. No failures occurred at the prosthetic level. Overall, higher VAS scores were reported for bar‐ compared with Locator‐retained prostheses. Furthermore, increased OHIP G14 values resulted for HNC‐TR/RT. Conclusions High survival rates on implant and prosthetic level were observed. The use of soft tissue grafts resulted in stabilization of the peri‐implant mucosa in irradiated patients. In terms of retention and chewing ability, participants preferred bars over Locator attachments.

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“…7 When faced with these situations, the alternative for rehabilitation include transsinus implants, 8,9 pterygoid implants and zygomatic implants. 10 The original technique implemented for zygomatic fixations recommended the insertion of implants through the interior of maxillary sinus from the remaining alveolar ridge, so that an apical anchorage of the zygomatic bone could be achieved. 11 However, despite being an innovative technique and with considerable success rates, some disadvantages have been observed, such as the need for preservation and elevation of the sinus membrane.…”

Section: Rehabilitation Of Atrophic Maxilla With Immediate Loading Of...mentioning

confidence: 99%

“…5,7 The use of extraoral implants for retention, 2,8 along with 3D digital and prototyping technologies, have contributed to increasing satisfactory aesthetic results of prostheses use. 7,9,10…”

mentioning

confidence: 99%

Oculofacial Prosthetic Rehabilitation Complemented With Temporary Fillers and Neurotoxin

Schnorr

Salazar-Gamarra

Latuff

et al. 2022

Journal of Craniofacial Surgery

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: Surgical treatment of head and neck cancer causes severe tissue loss, therefore, deformities and psychosocial consequences. In cases involving orbit exenteration, satisfactory reconstruction can only be achieved with prosthetic replacement, despite successful reconstructive plastic surgery. Extraoral implants, 3D scanning, and prototyping technologies have contributed to increase satisfactory aesthetic results of oculofacial prosthesis. However, to achieve prosthetic rehabilitation refinement, patients' biological tissues have been treated with injectable cosmetic adjuncts methods as complements to results. This study aimed to describe the use of botulinum toxin type A, hyaluronic acid, and calcium hydroxyapatite previously to oculofacial prostheses manufacturing, in 5 oncologic patients of a rehabilitation unit. Outcomes produced by additional cosmetic methods on tissues, prostheses planning, and overall facial rehabilitation were observed and registered by photographs. Botulinum toxin type A, hyaluronic acid, and calcium hydroxyapatite has shown to be useful in improving asymmetries, volumizing surgical depressions and dissembling atrophic scars. Presenting an additional resource to improve overall results, enabling the manufacturing of smaller, thinner, and better-fitting oculofacial prostheses. Limitations as chronic infection and necrosis episodes, related to filler injection into previously irradiated sites, were described. The temporary effect of the materials used generates a need for reapplications but increases the safety of such procedures and enables patients' cancer treatment follow-up.

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Virtual planning, simultaneous dental implantation and CAD/CAM plate fixation: a paradigm change in maxillofacial reconstruction

Cited by 14 publications

References 31 publications

“Three‐in‐one” patient‐specific surgical guides for simultaneous dental implants in fibula flap jaw reconstruction: A prospective case series

“Three‐in‐one” patient‐specific surgical guides for simultaneous dental implants in fibula flap jaw reconstruction: A prospective case series

Retrospective long‐term clinical evaluation of implant‐prosthetic rehabilitations after head and neck cancer therapy

Oculofacial Prosthetic Rehabilitation Complemented With Temporary Fillers and Neurotoxin

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