Individual prostheses and resection templates for mandibular resection and reconstruction.
This new technique uses helical computed tomography data and computer-aided design and manufacturing for preoperative fabrication of individual mandibular prostheses together with corresponding resection templates. Coherent 3D geometries for computer-based models are the basis for the construction of prostheses and provide data for a computerized numerical control fabrication. Fixation plates are fabricated with the titanium prostheses. The identical data of these plates are used for the computer-aided design and manufacturing of resection templates, which guide an oscillating saw in a precisely determined resection plane. This plane again is identical with the prostheses' margins for mandibular body replacement. The use of this technique in four patients is reported on: after temporary insertion of the templates for resection and after resection, the prostheses were stabilized with the same screws in the same screw-holes where the templates had been. Resection and reconstruction were thus highly precise, safe and fast and primarily led to excellent aesthetic and functional results. Wound-healing depends on a safe soft-tissue reconstruction over these large prostheses. Coverage with flaps seems obligatory. In spite of the superior technical aspects, the clinical long-term results of this new technique were poor.
Eufinger
H
H
Department of Oral and Maxillofacial Surgery--Regional Plastic Surgery at the University Hospital Knappschafts-Krankenhaus, Ruhr-University, Bochum, Germany.
Wehmöller
M
M
Machtens
E
E
D000328:Adult; D001863:Bone Screws; D002294:Carcinoma, Squamous Cell / Q000534:rehabilitation / Q000601:surgery; D017076:Computer-Aided Design; D005260:Female; D006801:Humans; D008297:Male; D008334:Mandible / Q000000981:diagnostic imaging / Q000601:surgery*; D008339:Mandibular Neoplasms / Q000534:rehabilitation / Q000601:surgery; D008341:Mandibular Prosthesis; D019930:Mandibular Prosthesis Implantation; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000534:rehabilitation / Q000601:surgery; D011474:Prosthesis Design; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome