Reconstruction of Mandible: A Fully Digital Workflow from Visualized Iliac Bone Grafting to Implant Restoration

Publication date: Available online 7 March 2017
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Taoran Tian, Tao Zhang, Quanquan Ma, Qi Zhang, Xiaoxiao Cai
PurposeWhile digital aids can help surgeons compensate for the shortcomings of traditional mandibular reconstruction techniques to perform surgery more precisely and effectively, the use of these digital techniques has often been fragmented, divided, and incomplete. In this article, we elaborate the workflow of a fully digital mandible reconstruction to explore proper indications, and discuss innovations based on the accuracy and effectiveness of digital techniques.MethodsWe performed a restoration-oriented mandibular reconstruction applying a variety of digital techniques. Pre-operative virtual surgery and rapid prototyping were utilized to aid the vascularized iliac bone graft surgery, which offered a solid basis for the following treatment. Subsequently, implant rehabilitation was accomplished with the assistance of CAD/CAM, laser treatment, and selective laser melting (SLM) techniques.ResultThe workflow of the fully digital mandibular reconstruction successfully achieved a restoration-oriented treatment. These predictable, accurate, and effective digital techniques improved the consistency of pretreatment design and follow-up treatment. The treatment sequence achieved high predictability and reproducibility owing to the use of digital techniques.ConclusionWe have shown that a digital workflow can be predictable, accurate, and effective, which suggests that it could be a valid digital protocol for developing a treatment sequence for patients with jaw defects caused by trauma, congenital anomalies, or mandibular tumor resection.



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