title: [Reconstruction in craniofacial contour and continuity defects with preoperatively designed individual implants].
abstract: Reconstruction of craniofacial bone defects with intraoperatively modeled prostheses restricts the choice of material and its biocompatibility and the prediction of the aesthetic result. This goes hand in hand with prolonged duration of the surgical procedure and increased stress for the patient. In contrast, modern industrial CAD/CAM systems allow prefabrication of titanium prostheses. Individual computer-based 3D models of the bony defect are generated after acquisition, transfer and evaluation of helical CT data. Based on these data, the individual shape of the prosthesis is designed using free-form surface geometry and fabricated by a numerically controlled milling machine. The conical margins of this prosthesis are designed with a precision of 0.25 mm to the borders of the defect, and the surface contours are generated harmonically to the non-affected neighboring contours with a constant thickness of 1.5 mm. Individual constructions for fixation with the dimensions of microplates are integrated in this process if screw-holes cannot be drilled in thin overlapping margins of the prosthesis. Reconstruction of 18 posttraumatic or postoperative cranial defects measuring up to 18 cm was performed using this new method. Wound-healing was uneventful in all cases, although some of the patients had been operated on several times before. The results were always predictable and constant using this highly precise technique, and duration of surgery was reduced dramatically.
authors.affiliation: Universitätsklinik für Mund-, Kiefer- und Gesichtschirurgie, Bochum.
authors.forename: H
authors.initials: H
authors.lastname: Eufinger
authors.forename: E
authors.initials: E
authors.lastname: Machtens
mesh_terms: D001672:Biocompatible Materials; D003399:Craniotomy / Q000295:instrumentation*; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000295:instrumentation*; D008447:Maxillofacial Prosthesis; D019931:Maxillofacial Prosthesis Implantation; D011474:Prosthesis Design; D017755:Prosthesis Fitting; D014057:Tomography, X-Ray Computed / Q000295:instrumentation*
chemical_list: D001672:Biocompatible Materials