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Application of CAD/CAM-assisted technique with surgical treatment in reconstruction of the mandible
Authors:Jin-Song Hou  Mu Chen  Chao-Bin Pan  Miao Wang  Jian-Guang Wang  Bin Zhang  Qian Tao  Cheng Wang  Hong-Zhang Huang
Institution:1. Department of Oral and Maxillofacial Surgery, Hospital of Stomatology, Guanghua School of Stomatology, and Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China;2. Department of Stomatology, Nanshan Affiliated Hospital of Guangdong Medical College, Shenzhen, China;3. Department of Oral and Maxillofacial Surgery, Second Af?liated Hospital, Sun Yat-sen University, Guangzhou, China;1. Department of Oral and Maxillofacial Surgery, Affiliated Stomatology Hospital of Kunming Medical University, No.193 Renmingxi Road, Kunming, Yunnan 650031, China;2. Department of Computer Tomography, Second Affiliated Hospital of Kunming Medical University, Kunming 650101, China;1. Resident, Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China;2. Resident, Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China;3. Associate Professor, Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China;4. Associate Professor, Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China;6. Professor, Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China;5. Professor, Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China;1. Former resident, Jonathan and Maxine Ferencz Advanced Education Program in Prosthodontics, New York University College of Dentistry, New York, NY;2. Former resident, Jonathan and Maxine Ferencz Advanced Education Program in Prosthodontics, New York University College of Dentistry, New York, NY;3. Director, Jonathan and Maxine Ferencz Advanced Education Program in Prosthodontics, New York University College of Dentistry, New York, NY;1. Assistant Professor, Department of Oral, Head and Neck Oncology and Microvascular Reconstructive Surgery, School of Dentistry, University of Texas Health Science Center at Houston, Houston, TX;2. Postgraduate Year 2 Resident, Department of Oral, Head and Neck Oncology and Microvascular Reconstructive Surgery, School of Dentistry, University of Texas Health Science Center at Houston, Houston, TX;3. Associate Professor, Department of Oral, Head and Neck Oncology and Microvascular Reconstructive Surgery, School of Dentistry, University of Texas Health Science Center at Houston, Houston, TX;4. Surgical Fellow, Department of Oral, Head and Neck Oncology and Microvascular Reconstructive Surgery, School of Dentistry, University of Texas Health Science Center at Houston, Houston, TX;1. Craniofacial Fellow, Yale Plastic Surgery, Department of Plastic and Reconstructive Surgery, Yale University School of Medicine, New Haven, CT;2. Medical Student, Yale University School of Medicine, Department of Plastic and Reconstructive Surgery, Yale University School of Medicine, New Haven, CT;3. Medical Student, Yale University School of Medicine, Department of Plastic and Reconstructive Surgery, Yale University School of Medicine, New Haven, CT;4. Visiting Research Fellow, Yale School of Medicine, Department of Plastic and Reconstructive Surgery, Yale University School of Medicine, New Haven, CT;6. Associate Professor Plastic Surgery; Director Craniomaxillofacial Surgery, Yale School of Medicine, Yale University School of Medicine, New Haven, CT; Department of Plastic and Reconstructive Surgery, Yale University School of Medicine, New Haven, CT;2. Department of Oral and Maxillofacial Surgery (Head: Priv. -Doz. Dr. med. Dr. med. dent. Henning Hanken), University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany;3. Institute of Biomechanics (Head: Prof. Dr. -habil. Michael M. Morlockc), TUHH Hamburg University of Technology, Denickestraße 15, 21703 Hamburg, Germany
Abstract:ObjectiveThe purpose of this clinical study was to explore the optimal method of reconstruct mandible defects individually and immediately.Study designThree-dimensional model simulation technique and vascularized fibular osteomyocutaneous flap were used to repair 15 cases of mandible defects, which were caused by ameloblastoma. A three-dimensional computed tomography (CT) images were converted to a virtual model using CAD software and the 3-dimensional (3D) simulated resin models of skeleton and ?bula were used to design the osteotomies, bone segment replacement and titanium mesh shaping preoperatively.ResultsFibula ?aps were alive and no complication occurred. The patients were satis?ed with the results both esthetically and functionally.ConclusionsThis preliminarily clinical study and case demonstrated that CAD/CAM-assisted technique with surgical treatment offers an individual anatomical reconstruction of the mandible in ameloblastoma patients. The procedures guarantee intraoperatively an exact placement of the preformed mesh even for precise reconstruction of extensive mandible defects.
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