The application of 3-D biomodeling technology in complex mandibular reconstruction—experience of 47 clinical cases

The application of 3-D biomodeling technology in complex mandibular reconstruction—experience... 3-D biomodeling technology associated with stereolithography has become a fundamental tool in reconstructive surgery in recent years as it enables a highly accurate definition of the defect to be reconstructed. In complex mandibular reconstruction using free flaps, the exact 3-D characteristics of the flap are decisive to restore symmetry and structural integrity, which enables a good functional and aesthetic result. This paper reports the application of an innovative 3-D biomodeling approach for the calculation of the exact contours, angles, length, and general morphology of iliac crest and fibula free flaps for mandibular reconstruction. Between 2003 and 2009, we managed 47 complex mandibular reconstruction cases using this technology. The free flaps used were fibula ( n = 29) and iliac crest ( n = 18) transferred as osseous or osteocutaneous flaps. From computer tomography scans, virtual 3-D images of the patient's anatomy were converted into 3-D physical models using first Freeform Modeling® software and then selective laser stereolithography technology. Intra-operative bone osteotomies and modeling were guided by these biomodels. Functional and aesthetic end results were at least considered satisfactory in 95.7% of the patients. The majority (80.8%) were in the good and very good end-result categories. This personalized designing of free flaps enabled optimization of pre-operative planning, reduced operative time, and significantly improved the aesthetic and bio-functional outcome. We found it to be particularly useful in major secondary defects (oncological, osteoradionecrosis, trauma) with important distortion of craniofacial structure, congenital malformations, and primary tumor surgery when the dimensions of the tumor have altered normal anatomy considerably. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png European Journal of Plastic Surgery Springer Journals

The application of 3-D biomodeling technology in complex mandibular reconstruction—experience of 47 clinical cases

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Publisher
Springer Journals
Copyright
Copyright © 2011 by Springer-Verlag
Subject
Medicine & Public Health; Plastic Surgery
ISSN
0930-343X
eISSN
1435-0130
D.O.I.
10.1007/s00238-010-0503-8
Publisher site
See Article on Publisher Site

Abstract

3-D biomodeling technology associated with stereolithography has become a fundamental tool in reconstructive surgery in recent years as it enables a highly accurate definition of the defect to be reconstructed. In complex mandibular reconstruction using free flaps, the exact 3-D characteristics of the flap are decisive to restore symmetry and structural integrity, which enables a good functional and aesthetic result. This paper reports the application of an innovative 3-D biomodeling approach for the calculation of the exact contours, angles, length, and general morphology of iliac crest and fibula free flaps for mandibular reconstruction. Between 2003 and 2009, we managed 47 complex mandibular reconstruction cases using this technology. The free flaps used were fibula ( n = 29) and iliac crest ( n = 18) transferred as osseous or osteocutaneous flaps. From computer tomography scans, virtual 3-D images of the patient's anatomy were converted into 3-D physical models using first Freeform Modeling® software and then selective laser stereolithography technology. Intra-operative bone osteotomies and modeling were guided by these biomodels. Functional and aesthetic end results were at least considered satisfactory in 95.7% of the patients. The majority (80.8%) were in the good and very good end-result categories. This personalized designing of free flaps enabled optimization of pre-operative planning, reduced operative time, and significantly improved the aesthetic and bio-functional outcome. We found it to be particularly useful in major secondary defects (oncological, osteoradionecrosis, trauma) with important distortion of craniofacial structure, congenital malformations, and primary tumor surgery when the dimensions of the tumor have altered normal anatomy considerably.

Journal

European Journal of Plastic SurgerySpringer Journals

Published: Aug 1, 2011

References

  • Navigational maxillofacial surgery using virtual models
    Hohlweg-Majert, B; Schön, R; Schmelzeisen, R; Gellrich, NC; Schramm, A
  • Custom made cranioplasty prostheses in porous hydroxy-apatite using 3D design techniques: 7 years experience in 25 patients
    Staffa, G; Nataloni, A; Compagnone, C; Servadei, F
  • Cerebrovascular biomodelling: a technical note
    D'Urso, PS; Thompson, RG; Atkinson, RL
  • Facial reconstruction using 3-D computer graphics
    Vanezi, P; Vanezis, M; McCombe, G; Niblett, T
  • Fetal biomodelling
    D'Urso, PS; Thompson, RG

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