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Recent Advances in Oral and Craniofacial Reconstruction

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A special issue of Bioengineering (ISSN 2306-5354). This special issue belongs to the section "Regenerative Engineering".

Deadline for manuscript submissions: closed (28 February 2023) | Viewed by 14750

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Special Issue Editors

Dr. Vincenzo Abbate

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Guest Editor

Department of Neuroscience and Reproductive and Odontostomatological Sciences, University of Naples Federico II, 80138 Naples, Italy
Interests: CAD–CAM technologies; minimally invasive surgery; endoscope-assisted surgery; virtual planning; 3D printing
Special Issues, Collections and Topics in MDPI journals

Dr. Guido Gabriele

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Guest Editor

Department of Oral and Maxillofacial Surgery, Università degli Studi di Siena, 53100 Siena, Italy
Interests: maxillofacial surgery; oral surgery; microsurgery; CAD–CAM technologies; minimally invasive surgery; endoscope-assisted surgery; virtual planning; 3D printing; telemedicine; sensors; haptic technologies; nanotechnologies
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The surgical treatment of maxillofacial pathologies cannot be separated from careful reconstructive planning. The head and neck area is the anatomical area of the body with the greatest aesthetic and functional value; therefore, the reconstructive phase is mandatory for the surgeon who treats pathologies in this region. Over the years, reconstructive techniques have evolved hand-in-hand with new technologies. From pedunculated flaps we moved to microvascular flaps and then to propeller flaps. Recently, the introduction of computer-assisted surgery (CAS) has revolutionized reconstructive techniques by offering the surgeon the possibility of planning the most suitable reconstruction for each individual case in advance. These new technologies will certainly influence the management of head and neck reconstruction over the next few years in regard to maximizing aesthetic and functional outcomes.

This Special Issue encourages researchers and clinicians to submit original research articles, technical notes, review articles and systematic reviews that address the current innovative reconstructive techniques in oral and maxillofacial surgery.

Potential topics include but are not limited to the following:

Virtual planning and rapid “in-house” prototyping for reconstructions of the head and neck area;
Innovative digital workflows for the treatment and reconstruction of patients suffering from maxillofacial trauma;
Innovative surgical approaches for head and neck reconstructions;
New reconstructive techniques based on microvascular flaps in patients suffering from head and neck cancer;
Novel solutions for the reconstruction of hard and soft tissues in the head and neck area based on CAD–CAM technologies;
3D printing in maxillofacial surgery;
Computer-assisted surgery in the treatment and reconstruction of patients with craniofacial malformation;
Surgical navigation applied to head and neck reconstructions.

Dr. Vincenzo Abbate
Dr. Guido Gabriele
Guest Editors

Manuscript Submission Information

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Keywords

head and neck cancer
maxillofacial trauma
craniofacial deformity
virtual planning
3D printing
in-house rapid prototyping

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Published Papers (6 papers)

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Research

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24 pages, 13581 KiB

Open AccessArticle

Bespoke Implants for Cranial Reconstructions: Preoperative to Postoperative Surgery Management System

by Mihaela-Elena Ulmeanu, Ileana Mariana Mateș, Cristian-Vasile Doicin, Marian Mitrică, Vasile Alin Chirteș, Georgian Ciobotaru and Augustin Semenescu

Bioengineering 2023, 10(5), 544; https://doi.org/10.3390/bioengineering10050544 - 29 Apr 2023

Cited by 4 | Viewed by 2193

Abstract

Traumatic brain injury is a leading cause of death and disability worldwide, with nearly 90% of the deaths coming from low- and middle-income countries. Severe cases of brain injury often require a craniectomy, succeeded by cranioplasty surgery to restore the integrity of the skull for both cerebral protection and cosmetic purposes. The current paper proposes a study on developing and implementing an integrative surgery management system for cranial reconstructions using bespoke implants as an accessible and cost-effective solution. Bespoke cranial implants were designed for three patients and subsequent cranioplasties were performed. Overall dimensional accuracy was evaluated on all three axes and surface roughness was measured with a minimum value of 2.209 μm for Ra on the convex and concave surfaces of the 3D-printed prototype implants. Improvements in patient compliance and quality of life were reported in postoperative evaluations of all patients involved in the study. No complications were registered from both short-term and long-term monitoring. Material and processing costs were lower compared to a metal 3D-printed implants through the usage of readily available tools and materials, such as standardized and regulated bone cement materials, for the manufacturing of the final bespoke cranial implants. Intraoperative times were reduced through the pre-planning management stages, leading to a better implant fit and overall patient satisfaction. Full article

(This article belongs to the Special Issue Recent Advances in Oral and Craniofacial Reconstruction)

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17 pages, 3994 KiB

Open AccessArticle

Biomechanical Evaluation of Temporomandibular Joint Reconstruction Using Individual TMJ Prosthesis Combined with a Fibular Free Flap in a Pediatric Patient

by Krzysztof Dowgierd, Edyta Kawlewska, Kamil Joszko, Jacek Kropiwnicki and Wojciech Wolanski

Bioengineering 2023, 10(5), 541; https://doi.org/10.3390/bioengineering10050541 - 27 Apr 2023

Cited by 1 | Viewed by 1829

Abstract

The main aim of this study was to perform a complex biomechanical analysis for a custom-designed temporomandibular joint (TMJ) prosthesis in combination with a fibular free flap in a pediatric case. Numerical simulations in seven variants of loads were carried out on 3D models obtained based on CT images of a 15-year-old patient in whom it was necessary to reconstruct the temporal-mandibular joints with the use of a fibula autograft. The implant model was designed based on the patient’s geometry. Experimental tests on a manufactured personalized implant were carried out on the MTS Insight testing machine. Two methods of fixing the implant to the bone were analyzed—using three or five bone screws. The greatest stress was located on the top of the head of the prosthesis. The stress on the prosthesis with the five-screw configuration was lower than in the prosthesis with the three-screw configuration. The peak load analysis shows that the samples with the five-screw configuration have a lower deviation (10.88, 0.97, and 32.80%) than the groups with the three-screw configuration (57.89 and 41.10%). However, in the group with the five-screw configuration, the fixation stiffness was relatively lower (a higher value of peak load by displacement of 171.78 and 86.46 N/mm) than in the group with the three-screw configuration (where the peak load by displacement was 52.93, 60.06, and 78.92 N/mm). Based on the experimental and numerical studies performed, it could be stated that the screw configuration is crucial for biomechanical analysis. The results obtained may be an indication for surgeons, especially during planning personalized reconstruction procedures. Full article

(This article belongs to the Special Issue Recent Advances in Oral and Craniofacial Reconstruction)

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11 pages, 37999 KiB

Open AccessFeature PaperArticle

Socket Preservation after Tooth Extraction: Particulate Autologous Bone vs. Deproteinized Bovine Bone

by Glauco Chisci, Arjeta Hatia, Elettra Chisci, Dafne Chisci, Paolo Gennaro and Guido Gabriele

Bioengineering 2023, 10(4), 421; https://doi.org/10.3390/bioengineering10040421 - 27 Mar 2023

Cited by 17 | Viewed by 4532

Abstract

Background: The technique of socket preservation after tooth extraction allows for less volumetric decrease after tooth extraction. The aim of this retrospective study was to evaluate differences between alveolar socket preservation performed with deproteinized bovine bone graft and autologous particulate bone graft taken from the mandibular ramus. Materials and Methods: This retrospective study enrolled a total of 21 consecutive patients. A total of 11 patients underwent socket preservation with deproteinized bovine bone graft and collagen matrix (group A), and 10 patients underwent socket preservation performed with particulate autologous bone taken from the mandibular ramus and collagen matrix (group B). All patients received cone beam computed tomography (CBCT) before socket preservation and after four months. Alveolar bone width (ABW) values and alveolar bone height (ABH) values were measured at the first and second CBCT, and the reduction of the values in the two groups was compared. Statistical analysis was performed using Student’s t-test for independent variables, and p values < 0.05 were considered statistically significant. Results: There were no statistically significant differences between ABW reduction of group A and ABW reduction of group B (t-test value p = 0.28). There were no statistically significant differences between ABH reduction of group A and ABH reduction of group B (t-test value p = 0.10). Conclusions: In this retrospective study, no statistical differences were found between the group that received autologous particulate bone compared to the group that received deproteinized bovine bone in socket preservation. Full article

(This article belongs to the Special Issue Recent Advances in Oral and Craniofacial Reconstruction)

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11 pages, 854 KiB

Open AccessArticle

Morphological Study of the Mandibular Lingula and Antilingula by Cone-Beam Computed Tomography

by Chun-Ming Chen, Hui-Na Lee, Shih-Wei Liang and Kun-Jung Hsu

Bioengineering 2023, 10(2), 170; https://doi.org/10.3390/bioengineering10020170 - 28 Jan 2023

Cited by 2 | Viewed by 1838

Abstract

The patterns of the lingula and antilingula are crucial surgical reference points for ramus osteotomy. Cone-beam computed tomography (CBCT) provides three-dimensional images, and patient radiation dose is significantly lower for CBCT than for medical CT. The morphology of the mandibular lingula and antilingula of ninety patients (180 sides) were investigated using CBCT. The lingula were classified as having triangular, truncated, nodular, and assimilated shapes. The antilingula were classified as having hill, ridge, plateau, and plain shapes. The patients’ sex, skeletal patterns (Classes I, II, and III), and right and left sides were recorded. The most to least common lingula shapes were nodular (37.8%), followed by truncated (32.8%), triangular (24.4%), and assimilated (5%). The most to least common antilingulae were hill (62.8%), plain (18.9%), plateau (13.9%), and ridge (4.4%) patterns, respectively. The lingula and antilingula had identical patterns on both sides in 47 (52.2%) and 46 patients (51.1%), respectively. Sex and skeletal pattern were not significantly correlated to lingula and antilingula shapes. No significant correlation was observed between lingula and antilingula shapes. Full article

(This article belongs to the Special Issue Recent Advances in Oral and Craniofacial Reconstruction)

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7 pages, 223 KiB

Open AccessArticle

Changes in Preexisting Temporomandibular Joint Clicking after Orthognathic Surgery in Patients with Mandibular Prognathism

by Chun-Ming Chen, Pei-Jung Chen and Han-Jen Hsu

Bioengineering 2022, 9(12), 725; https://doi.org/10.3390/bioengineering9120725 - 24 Nov 2022

Cited by 1 | Viewed by 1564

Abstract

This study aimed to investigate the changes in preexisting temporomandibular joint (TMJ) clicking and the new incidence of TMJ clicking after orthognathic surgery. A total of 60 patients (30 men and 30 women) with mandibular prognathism underwent intraoral vertical ramus osteotomy (IVRO) for a mandibular setback. The setback amount and TMJ clicking symptoms (preoperative and one year postoperative) were recorded. To assess the risk of new incidence of TMJ clicking in asymptomatic patients, the cutoff value for postoperative mandibular setback was set at 8 mm. The left and right mandibular setbacks were 11.1 and 10.9 mm in men, respectively, and 10.7 and 10.0 mm in women, respectively. Thus, no difference in setback amount on either side was observed between the sexes. The improvement rate in patients with preexisting TMJ clicking was 69.2% (18 of 26 sides); the postoperative improvement rates were 71.4% (setback amount > 8 mm) and 60% (setback amount ≤ 8 mm). IVRO may reduce the severity of preexisting TMJ clicking. A high setback amount (>8 mm) may not be associated with a considerable increase in the risk of postoperative TMJ clicking. Full article

(This article belongs to the Special Issue Recent Advances in Oral and Craniofacial Reconstruction)

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23 pages, 756 KiB

Open AccessReview

The Use of Tactile Sensors in Oral and Maxillofacial Surgery: An Overview

by Pietro Navalesi, Calogero Maria Oddo, Glauco Chisci, Andrea Frosolini, Paolo Gennaro, Vincenzo Abbate, Domenico Prattichizzo and Guido Gabriele

Bioengineering 2023, 10(7), 765; https://doi.org/10.3390/bioengineering10070765 - 26 Jun 2023

Cited by 9 | Viewed by 2009

Abstract

Background: This overview aimed to characterize the type, development, and use of haptic technologies for maxillofacial surgical purposes. The work aim is to summarize and evaluate current advantages, drawbacks, and design choices of presented technologies for each field of application in order to address and promote future research as well as to provide a global view of the issue. Methods: Relevant manuscripts were searched electronically through Scopus, MEDLINE/PubMed, and Cochrane Library databases until 1 November 2022. Results: After analyzing the available literature, 31 articles regarding tactile sensors and interfaces, sensorized tools, haptic technologies, and integrated platforms in oral and maxillofacial surgery have been included. Moreover, a quality rating is provided for each article following appropriate evaluation metrics. Discussion: Many efforts have been made to overcome the technological limits of computed assistant diagnosis, surgery, and teaching. Nonetheless, a research gap is evident between dental/maxillofacial surgery and other specialties such as endovascular, laparoscopic, and microsurgery; especially for what concerns electrical and optical-based sensors for instrumented tools and sensorized tools for contact forces detection. The application of existing technologies is mainly focused on digital simulation purposes, and the integration into Computer Assisted Surgery (CAS) is far from being widely actuated. Virtual reality, increasingly adopted in various fields of surgery (e.g., sino-nasal, traumatology, implantology) showed interesting results and has the potential to revolutionize teaching and learning. A major concern regarding the actual state of the art is the absence of randomized control trials and the prevalence of case reports, retrospective cohorts, and experimental studies. Nonetheless, as the research is fast growing, we can expect to see many developments be incorporated into maxillofacial surgery practice, after adequate evaluation by the scientific community. Full article

(This article belongs to the Special Issue Recent Advances in Oral and Craniofacial Reconstruction)

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