How accurate is computer-assisted mandible gunshot wound management by patient-specific distraction device? Preoperative planning versus postoperative outcomes |
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| Institution: | 1. Department of Maxillofacial and Plastic Surgery, Caen University Hospital, Caen, France;2. Normandie Université, Unicaen, BioConnect, Caen, France;3. Medecine Faculty of Caen, University of Caen Basse Normandie, Caen, France;1. Department of Oral Medicine, Seoul National University Gwanak Dental Hospital, Seoul, South Korea;2. Department of Dental Hygiene, Yonsei University Graduate School, Seoul, South Korea;3. Department of Oral Medicine and Oral Diagnosis, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, South Korea;4. Institute on Aging, Seoul National University, Seoul, South Korea;1. Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA;2. Department of Oral and Maxillofacial Surgery, Harvard School of Dental Medicine, Boston, Massachusetts, USA;3. Department of Oral and Maxillofacial Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland;1. Oral and Maxillofacial Surgery Section, Faculty of Dentistry, Prince of Songkla University, Hat Yai, Songkhla, Thailand;2. Preventive Dentistry Section, Faculty of Dentistry, Prince of Songkla University, Hat Yai, Songkhla, Thailand;1. Department of Oral and Maxillofacial Surgery, Dr. D. Y. Patil Dental College and Hospital, Dr. D. Y. Patil Vidyapeeth, Pimpri, Pune, India;2. Deparment of Head and Neck Surgical Oncology, ACTREC, TMC, Khargar, Navi Mumbai, India;1. Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China;2. Department of Stomatology, Liangxiang Hospital of Beijing Fangshan District, Beijing, China;3. Institute of Quantitative Economics, School of Economics, Nankai University, Tianjin, China;1. State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China;2. Department of Oral and Maxillofacial Surgery, College of Dentistry, Ibb University, Ibb, Yemen;3. School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, China |
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| Abstract: | Gunshot wounds of the lower face are a challenge for the surgeon. Customized distraction osteogenesis (DO) is a well-established procedure for managing facial gunshot wounds. However, differences between the preoperative planning and postoperative outcomes are often noted. This multi-centre, retrospective study was performed to analyse the differences between the planning and outcomes for the lower third of the face, in patients undergoing the computer-assisted repair of mandible gunshot wounds using patient-specific distraction devices. Different planes and points were defined, and two distances (anteroposterior and intercondylar lengths) and an angle (inter-mandible body angle) were measured on the preoperative planning models and the postoperative models obtained from the computed tomography data. Twelve patient cases that met the study eligibility criteria were included. A significant difference between the planning and postoperative outcome was found for the anteroposterior length (6.6 mm shorter than the preoperative planning; P = 0.003). The differences in intercondylar length (P = 0.116) and inter-mandible body angle (P = 0.121) were not significant. This study revealed a difference between the planning and outcomes. Various factors such as scar tissue and muscle forces limit distraction and therefore lead to under-correction with insufficient projection. |
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| Keywords: | Computer-aided design Distraction osteogenesis Gunshot wounds Mandibular injuries Ilizarov technique |
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