Reconstruction of Maxillary and Orbital Floor Defect With Free Fibula Flap and Whole Individualized Titanium Mesh Assisted by Computer Techniques
| Autor: | Wei-Liu Qiu, Kun Fu, Yiming Liu, Ning Gao, Jinghua Cai, Wei He |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty Esthetics Radiography Free Tissue Flaps Patient Care Planning User-Computer Interface Young Adult 03 medical and health sciences Imaging Three-Dimensional 0302 clinical medicine Free fibula Image Interpretation Computer-Assisted Maxilla medicine Humans Prospective Studies Clinical efficacy Aged Maxillary Neoplasms Titanium Vascularized Composite Allotransplantation Orthodontics Bone Transplantation business.industry Jaw movement 030206 dentistry Middle Aged Surgical Mesh Models Dental Surgery Surgical mesh Surgery Computer-Assisted Otorhinolaryngology 030220 oncology & carcinogenesis Female Tomography Mandibular Reconstruction Oral Surgery Computer techniques Tomography X-Ray Computed business Orbit Follow-Up Studies |
| Zdroj: | Journal of Oral and Maxillofacial Surgery. 75:1791.e1-1791.e9 |
| ISSN: | 0278-2391 |
| DOI: | 10.1016/j.joms.2017.03.054 |
| Popis: | Purpose We sought to investigate the clinical application of free fibula flap and individualized titanium mesh through the use of a virtual planning and guiding template to assist the reconstruction of maxilla and orbital floor defects. Patients and Methods Between 2015 and 2016, a total of 6 adult patients with maxillary and orbital floor defects were enrolled in this study. Preoperative virtual planning, including virtual maxillary resection and fibular reconstruction, was performed in all cases according to 3-dimensional radiographic and clinical findings. A 3-dimensionally printed resin model and prebent templates were used to guide the harvesting and positioning of the fibula flap during surgery. Then, an individualized titanium mesh was used to support the orbital floor and restore the maxillary contour. The results were confirmed by postoperative computed tomography scans and clinical follow-up. Results Preoperative virtual planning and prebent templates can be used to guide the harvesting and positioning of the fibula flap, as well as the forming and positioning of the individualized titanium mesh, with satisfactory results. All flaps survived, and symmetrical facial contours were achieved with normal lower jaw movement and proper vertical distance for dental implants in all patients. Conclusions Computer-aided techniques such as virtual planning, 3-dimensionally printed models, and prebent guide templates can be used to harvest and position a free fibula flap, form personalized titanium mesh, and ultimately improve the clinical efficacy of maxillary and orbital floor reconstruction. |
| Databáze: | OpenAIRE |
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