Triple-Cut Computer-Aided Design-Computer-Aided Modeling: More Oncologic Safety Added to Precise Mandible Modeling.

Triple-Cut Computer-Aided Design-Computer-Aided Modeling: More Oncologic Safety Added to Precise Mandible Modeling.

J Oral Maxillofac Surg. 2017 Mar 24;:

Authors: Ramella V, Franchi A, Bottosso S, Tirelli G, Novati FC, Arnež ZM

Abstract
PURPOSE: Computer-aided design-computer-aided modeling (CAD-CAM) has become standard in mandibular reconstruction because it offers better outcomes. Occasionally, the reconstructive plans need to be changed intraoperatively and the custom-made prefabricated devices may become inadequate. We present an efficient adjunct to the standard CAD-CAM technique that resolves this problem.
MATERIALS AND METHODS: Customized surgical devices with our "triple-cut" concept were used in 5 patients for mandibular reconstruction with free fibula flap (4 after mandibular resection for squamous cell carcinoma and 1 after mandibular osteoradionecrosis). In all patients the mandibular and fibular cutting guides were provided with 3 different cutting levels per side.
RESULTS: Three different cutting levels on the mandible permitted an accurate resection based on the intraoperative needs. The corresponding 3 "cutting levels" on the fibula created perfectly matching segments of vascularized bone. Good contact of bony segments was obtained in all patients.
CONCLUSIONS: The prefabricated triple-cut cutting guides make changing the dimensions of bony resection, while still using the prefabricated CAD-CAM reconstructive plate, possible.

PMID: 28419844 [PubMed - as supplied by publisher]

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