Classical versus custom orbital wall reconstruction: Selected factors regarding surgery and hospitalization.
OBJECTIVE
Nowadays, in orbital wall reconstruction, maxillofacial surgeons have the possibility to treat patients in modern ways such as with individual implants. Nevertheless, conventional treatment including standard titanium mesh shaped during the surgical procedure is also widely used. The aim of this study was to compare the above methods of orbital wall reconstructions.


METHODS
In the first group (39 cases), patients were treated by means of computer-aided design/computer-aided manufacturing (CAD/CAM) milled individual implants made of ultra-high-molecular-weight polyethylene, dioxide zirconium and rapid prototyping titanium mesh pre-bent on an ABS model made by a three-dimensional (3D) printer. In the second group (54 cases), intraoperative bending of titanium mesh was implemented.


RESULTS
Ophthalmologic outcomes were the same in both groups. In patients who had greater destruction of the orbit, surgical procedures were longer regardless of the material used for individual implants (p < 0.05). Time of surgery was shorter in patients in whom individual implants were used. Intraoperative bleeding was higher in patients who were treated using intraoperative bending titanium mesh (p < 0.01).


CONCLUSIONS
Application of CAD/CAM techniques do not give better ophthalmologic results in reference center but improve patient condition postoperatively. For this reason, CAD/CAM is a safer treatment method for patients.
Department of Maxillofacial Surgery (Head: Prof. Marcin Kozakiewicz, DDS), Medical University of Lodz, 1st Haller pl., 90-647 Lodz, Poland. Electronic address: bkost@op.pl.
Rafał
R
Zieliński
Medical University of Lodz, Poland. Electronic address: marta.malinska7@wp.pl.
Marta
M
Malińska
Department of Maxillofacial Surgery (Head: Prof. Marcin Kozakiewicz, DDS), Medical University of Lodz, 1st Haller pl., 90-647 Lodz, Poland.
Marcin
M
Kozakiewicz
D000328:Adult; D017076:Computer-Aided Design; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay; D008297:Male; D061646:Operative Time; D009915:Orbit / Q000601:surgery*; D009917:Orbital Fractures / Q000601:surgery*; D019736:Prostheses and Implants; D011474:Prosthesis Design; D019919:Prosthesis Implantation; D019651:Plastic Surgery Procedures / Q000379:methods*; D013526:Surgical Mesh; D014025:Titanium
D014025:Titanium
CAD; CAM; Custom implant; Orbital reconstruction