Saponaro G, Doneddu P, Gasparini G, Staderini Edoardo, Boniello R, Todaro M, D'Amato G, Pelo S, Moro A
Maxillo-Facial Surgery Unit, IRCCS Fondazione Policlinico "A. Gemelli", Università Cattolica del Sacro Cuore, Rome, Italy.
Institute of Dentistry and Maxillo-Facial Surgery, IRCCS Fondazione Policlinico "A. Gemelli", Università Cattolica del Sacro Cuore, Rome, Italy.
Childs Nerv Syst. 2020 Feb;36(2):385-391. doi: 10.1007/s00381-019-04307-9. Epub 2019 Jul 31.
Facially malformed patients often present a variable degree of facial imbalance even after basal bone correction, and resolution of the residual hard- and soft-tissue deficiencies and asymmetries of the face are of great importance for achieving a satisfactory post-implant procedure result. The use of polyether ether ketone (PEEK) implants for maxillofacial reconstruction has been documented in the literature, but the number of patients who have received them is limited. The aim of this study was to evaluate the overall volumetric results in patients with facial imbalance after onlay custom implant positioning for mandible and fronto-orbital reconstructions. Analysis was performed by confronting volumes with the use of three-dimensional (3D) photogrammetry.
Fifteen patients were eligible for PEEK implant placements, eight for mandibular angle reconstruction, and seven for fronto-orbital reconstruction. Pre- and post-surgical 3D images of each patient's face were acquired. Facial asymmetry was analyzed by comparing each face with its mirrored copy.
Three-dimensional analyses have shown that some degree of volume imbalance was still present in the patients with only 1.32 ± 1.02 mm residual discrepancy after treatment.
Results of the study were found to fall within clinically acceptable limits since an asymmetry rate of < 3 mm is considered to fall into the norm.
面部畸形患者即使在基础骨矫正后也常存在不同程度的面部不对称,解决面部残留的软硬组织缺陷和不对称对于获得满意的植入后手术效果至关重要。文献中已有使用聚醚醚酮(PEEK)植入物进行颌面重建的记载,但接受此类植入物的患者数量有限。本研究的目的是评估在定制植入物植入下颌骨和额眶重建后,面部不对称患者的整体容积结果。通过使用三维(3D)摄影测量法对比容积进行分析。
15例患者符合PEEK植入条件,其中8例用于下颌角重建,7例用于额眶重建。采集每位患者术前和术后的面部3D图像。通过将每张脸与其镜像进行比较来分析面部不对称情况。
三维分析表明,治疗后残留差异仅为1.32±1.02毫米的患者仍存在一定程度的容积不平衡。
由于不对称率<3毫米被认为属于正常范围,研究结果被发现在临床可接受范围内。