The Utilization of Computer Aided Design and Manufacturing in Acute Mandibular Trauma Reconstruction

Publication date: Available online 13 December 2017
Source:Journal of Oral and Maxillofacial Surgery
Author(s): George Kokosis, Edward H. Davidson, Rachel Pedreira, Alexandra Mcmillan, Amir H. Dorafshar
PurposeVirtual surgical planning (VSP) with subsequent computer aided design and manufacturing (CAD/CAM) have proved efficacious in improving efficiency and outcomes of a plethora of surgical modalities including mandibular reconstruction and orthognathic surgery.MethodsFive patients underwent complex mandibular reconstruction following traumatic injury, utilizing VSP from July 2016 until August 2017 at our institution. The institutional review board at the Johns Hopkins University Hospital approved this study. The patient`s occlusion was restored virtually and a milled 2.0 mm plate was created that would bridge the defect with the patient in occlusion.ResultsAppropriate occlusion was confirmed with postoperative CT scan. No patient developed any adverse outcomes except a minor dehiscence of the intraoral incision in one, treated with local wound care. The average time from injury to the custom plate availability was approximately 7 days.ConclusionThe utility of this technology in acute complex mandibular trauma can overcome the challenges of traditional treatment; custom patient specific pre-bent and milled plates permit the use of lower profile and therefore less palpable hardware, can guide reduction, avoid the need for plate bending and obviate the need for an extraoral incision.



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