Search Results (4)

Virtual planning is ideally suited for maxillofacial operations as it allows the surgeon to assess the bony and critical neurovascular structures and enables him to plan osteotomies and fracture reductions. This study aims to propose the use of titanium-based patient-specific implants (PSI), along with virtual surgical planning to assess the advantages and the complications in a case of orbital reconstruction. A three-dimensional model of the skull was generated using computed tomography (CT) data of a female patient using Mimics software (version 19, Materialize, Leuven, Belgium). Numerical PSI models were designed using 3-Matic software (version 13, Materialize, Leuven, Belgium) and the non-affected orbit as a template. Surgical virtual planning showed the suitability of the use of the numerical models in traumatic surgical rehabilitation. Moreover, the digital printing process enabled the trial of the designed PSIs on the patient’s face before the surgery. Reconstruction Biomechanical studies are an essential part of understanding the limits of maxillofacial traumas. The surgical results confirmed the virtual predictions, and the orbital reconstruction seems to be more enhanced and facilitated. Full article

The effect of a novel nano-ceramic coating (TiO₂) using an atomic layer deposition (ALD) technique on the surface of polymethyl methacrylate (PMMA) material was investigated. The patients’ and clinicians’ perception and acceptance of the PMMA color with TiO₂ coating were also examined. In vitro color measurement was performed on thirty specimens (light, original, and dark pink) before and after TiO₂ coating. Patients’ and clinicians’ perception and acceptance of color changes on PMMA were measured and compared. Descriptive and analytic statistics were analyzed (a = 0.05). TiO₂ films were successfully deposited on the PMMA specimen by the ALD technique. Color changes after TiO₂ coating were observed on all three PMMA shades, significantly higher than the established 50:50% perceptibility threshold, but below the established 50:50% acceptability threshold. The percentage of patients that perceived a color difference after TiO₂ coating were 83.3%, 63.9%, and 77.8% for light, original, and dark pink, respectively. The percentages of clinicians that were satisfied with the color difference were 96.4%, 80%, and 69.2% for light, original, and dark pink, respectively. Color changes after TiO₂ coating were observed, but below the acceptable threshold. The clinical survey demonstrated that a color difference was perceived but was clinically acceptable. In general, laypeople have lower perception and higher acceptance of changes in PMMA color than clinicians. Full article

Purpose: Computer-aided methods for mandibular reconstruction have improved both functional and morphological results in patients who underwent segmental mandibular resection. The purpose of this study is to evaluate the overlaying of virtual planning in terms of measures of the Computer Assisted Design/Computer Assisted Manufacturing CAD/CAM plate for mandibular reconstruction in patients who are ineligible for the insertion of reconstructing the titanium plate supported by fibular free flap, due to their poor health status, or in the presence of specific contraindications to autologous bone flap harvest. Materials and methods: The retrospective study performed analyzed the results of nine patients. The patients were treated at the Maxillofacial Surgery Unit of Policlinico S. Orsola of Bologna, Italy, and Policlinico San Marco, Catania, Italy, from April 2016 to June 2021. Superimposition between planning and post operative Computed Tomography CT scan was performed to assess the accuracy. Results: All reconstructive procedures were carried out successfully. No microsurgery-related complications occurred. In two cases, we had plate misplacement, and in one case, plate exposure that led to plate removal. The average accuracy of the series assessed after CT superimposition, as previously described, was 0.95 mm. Conclusions: Considering that microvascular bone transfer is a high-risk procedure in BRONJ patients, we can conclude that the positioning of a customized bridging mandibular prosthesis (CBMP), whether or not it is associated with a microvascular soft tissue transfer, is a safe technique in terms of surgical outcome and feasibility. Full article

Direct Laser Metal Sintering (DLMS) is an additive manufacturing (AM) technique that is capable of manufacturing metal parts according to a three-dimensional (3D) design made using computer-assisted-design (CAD) software, thanks to a powerful laser beam that melts selectively micro-powder layers, one on top of the other, until the desired object is generated. With DMLS, it is now possible to fabricate custom-made titanium implants for oral and maxillofacial applications. We present the case of a 67-year-old woman diagnosed with a squamous cell carcinoma of the mandible. The patient underwent subtotal mandibular resection; conventional reconstruction procedures failed to rehabilitate the function of the mandible. A prosthesis replacing the resected mandible was designed and fabricated using a digital workflow. The extensive bone defect was rehabilitated with a prosthesis replacing the mandibular bone and supporting a morse-taper dental prosthesis. The masticatory function was reestablished. Full article