Oral and Maxillofacial Surgery, Faculty of Dentistry, Cairo University, Egypt.
Oral and Maxillofacial Surgery, Nasser Institute Hospital, Egypt.
J Craniomaxillofac Surg. 2021 Oct;49(10):943-949. doi: 10.1016/j.jcms.2021.05.001. Epub 2021 May 24.
The main aim of this study was to evaluate the accuracy of immediate CAD/CAM reconstruction of the temporal hollowing following temporalis muscle surgery, using a patient-specific implant (PSI) PEKK model. This case series included ten patients who underwent maxillofacial reconstruction using temporalis muscle flap (TMF). The study involved the preoperative planning and fabrication of the temporal implant using virtual surgical planning software. The planning was based on multislice CT scans, from which DICOM files were used to fabricate a 3D model of the temporalis muscle using polyetherketoneketone (PEKK). The patients were followed up for 12 months, to check for any signs of infection or mobilization, and to assess accuracy. At the end of the follow-up period, all the patients showed acceptance of the external appearance, with no signs of infection or rejection. These customized implants were measured and compared with their original 3D preoperative planning using a point-based analysis. This revealed a mean difference (±SD) of 0.0373 (±0.3036) mm and a median difference (Q1 to Q3) of 0.0809 (-0.2108 to 0.2769) mm. The study demonstrated that a highly accurate duplication of PSIs can be achieved using this template-molding workflow. The use of PEKK PSIs resulted in uneventful healing and esthetic acceptance by the patients and, therefore, is a relevant treatment option when temporal hollowing has to be corrected.
本研究的主要目的是评估使用患者特异性植入物 (PSI) PEKK 模型对颞肌手术后颞骨凹陷进行即时 CAD/CAM 重建的准确性。该病例系列包括 10 名接受颞肌皮瓣 (TMF) 进行颌面重建的患者。该研究涉及使用虚拟手术规划软件进行术前规划和颞部植入物的制作。规划基于多层 CT 扫描,从中使用 DICOM 文件使用聚醚酮酮 (PEKK) 制作颞肌的 3D 模型。对患者进行了 12 个月的随访,以检查是否有感染或移动的迹象,并评估准确性。在随访期末,所有患者均对外貌表示接受,无感染或排斥迹象。这些定制植入物被测量并与原始的 3D 术前规划进行比较,使用基于点的分析。结果显示,平均差异 (±SD) 为 0.0373 (±0.3036) mm,中位数差异 (Q1 至 Q3) 为 0.0809 (-0.2108 至 0.2769) mm。该研究表明,使用这种模板成型工作流程可以实现 PSI 的高度精确复制。PEKK PSI 的使用导致患者无并发症愈合和美学接受,因此,当需要纠正颞骨凹陷时,这是一种相关的治疗选择。