title: Computer-aided design and manufacturing construction of a surgical template for craniofacial implant positioning to support a definitive nasal prosthesis.
abstract: OBJECTIVE
  To design a surgical template to guide the insertion of craniofacial implants for nasal prosthesis retention.
  
  
  METHODS
  The planning of the implant position was obtained using software for virtual surgery; the positions were transferred to a free-form computer-aided design modeling software and used to design the surgical guides. A rapid prototyping system was used to 3D-print a three-part template: a helmet to support the others, a starting guide to mark the skin before flap elevation, and a surgical guide for bone drilling. An accuracy evaluation between the planned and the placed final position of each implant was carried out by measuring the inclination of the axis of the implant (angular deviation) and the position of the apex of the implant (deviation at apex).
  
  
  RESULTS
  The implant in the glabella differed in angulation by 7.78°, while the two implants in the premaxilla differed by 1.86 and 4.55°, respectively. The deviation values at the apex of the implants with respect to the planned position were 1.17 mm for the implant in the glabella and 2.81 and 3.39 mm, respectively, for those implanted in the maxilla.
  
  
  CONCLUSIONS
  The protocol presented in this article may represent a viable way to position craniofacial implants for supporting nasal prostheses.
authors.affiliation: Maxillo-Facial Prosthodontics, Section of Prosthodontics, Department of Oral Science, Alma Mater Studiorum University of Bologna, Bologna, Italy. leonardo.ciocca@unibo.it
authors.forename: Leonardo
authors.initials: L
authors.lastname: Ciocca
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Fantini
authors.forename: Francesca
authors.initials: F
authors.lastname: De Crescenzio
authors.forename: Franco
authors.initials: F
authors.lastname: Persiani
authors.forename: Roberto
authors.initials: R
authors.lastname: Scotti
mesh_terms: D003198:Computer Simulation; D017076:Computer-Aided Design; D005624:Frontal Bone / Q000601:surgery; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D007834:Lasers; D008297:Male; D008437:Maxilla / Q000601:surgery; D008875:Middle Aged; D008953:Models, Anatomic; D009296:Nasal Cavity / Q000601:surgery; D009666:Nose / Q000293:injuries / Q000601:surgery*; D016348:Osseointegration / Q000502:physiology; D010027:Osteotomy / Q000295:instrumentation; D010347:Patient Care Planning; D019736:Prostheses and Implants; D019651:Plastic Surgery Procedures / Q000295:instrumentation*; D012984:Software; D013524:Surgical Flaps; D014057:Tomography, X-Ray Computed / Q000379:methods; D014584:User-Computer Interface; D014948:Wounds, Gunshot / Q000601:surgery