title: [Reconstruction of mandibular bone defects using three-dimensional skull model and individualized titanium prosthetics from computer assisted design].
abstract: OBJECTIVE
  To evaluate the feasibility and effectiveness of reconstruction of mandibular bone defects using three-dimensional skull model and individualized titanium prosthetics from computer assisted design.
  
  
  METHODS
  Between July 2002 and November 2009, 9 patients with mandibular defects accepted restorative operation using individualized bone prosthetics. Among 9 cases, 4 were male and 5 were female, aged 19-55 years. The causes of mandibulectomy were benign lesions in 8 patients and carcinoma of gingival in 1 patient. Mandibular defects exceeded midline in 2 cases, involved condylar in 4 cases, and was limited in one side without involvement of temporo-mandibular joint in 3 cases. The range of bone defects was 9.0 cm x 2.5 cm-17.0 cm x 2.5 cm. The preoperative spiral CT scan was performed and three-dimensional skull model was obtained. Titanium prosthetics of mandibular defects were designed and fabricated through multi-step procedure of reverse engineering and rapid prototyping. Titanium prosthetics were used for one-stage repair of mandibular bone defects, then two-stage implant denture was performed after 6 months.
  
  
  RESULTS
  The individualized titanium prosthetics were inserted smoothly with one-stage operative time of 10-23 minutes. All the cases achieved incision healing by first intention and the oblique mandibular movement was corrected. They all got satisfactory face, had satisfactory contour and good occlusion. In two-stage operation, no loosening of the implants was observed and the abutments were in good position with corresponding teeth which were designed ideally before operation. All cases got satisfactory results after 1-9 years of follow-up. At last follow-up, X-ray examinations showed no loosening of implants with symmetry contour.
  
  
  CONCLUSIONS
  Computer assisted design and three-dimensional skull model techniques could accomplish the design and manufacture of individualized prosthetic for the repair of mandibular bone defects.
authors.affiliation: Department of Stomatology, Fuzhou General Hospital, Nanjing Military Area Command of Chinese PLA, Fuzhou Fujian, 350025, P R China.
authors.forename: Zhenyu
authors.initials: Z
authors.lastname: Gong
authors.forename: Guohua
authors.initials: G
authors.lastname: Li
authors.forename: Yanpu
authors.initials: Y
authors.lastname: Liu
authors.forename: Lisheng
authors.initials: L
authors.lastname: He
authors.forename: Bing
authors.initials: B
authors.lastname: Zhou
authors.forename: Dichen
authors.initials: D
authors.lastname: Li
mesh_terms: D000328:Adult; D017076:Computer-Aided Design; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008334:Mandible / Q000473:pathology / Q000601:surgery*; D019930:Mandibular Prosthesis Implantation / Q000295:instrumentation* / Q000379:methods; D008875:Middle Aged; D008962:Models, Theoretical; D011474:Prosthesis Design; D055815:Young Adult