Shilo Dekel, Capucha Tal, Krasovsky Andrei, Blanc Ori, Emodi Omri, Haze Amir, Rachmiel Adi
From the Department of Oral and Maxillofacial Surgery, Rambam Medical Care Center, Haifa, Israel.
Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
Plast Reconstr Surg Glob Open. 2024 Mar 20;12(3):e5645. doi: 10.1097/GOX.0000000000005645. eCollection 2024 Mar.
Comminuted fractures of the jaws are complex injuries requiring special attention. In the past, treatment included closed reduction using maxillomandibular fixation. With advancements in technology and fixation systems, open reduction became a prevalent option. These fractures are difficult to reconstruct during the primary treatment phase, thus resulting in higher complication rates. The introduction of three-dimensional (3D) planning and printing brought about superior outcomes, yet these focus on secondary reconstruction due to the need for outsourcing planning and titanium printing.
In this report, we describe real-time in-house 3D planning and printing using computer-assisted design software and a 3D-fused deposition printer for virtual reduction of the comminuted fractures and printing of the reconstructed mandible.
Following virtual 3D reduction, the newly created mandibles were 3D printed. The model was then used to preband a reconstruction plate, which in turn was used as a template during surgery for reducing the segments. The process of virtual reduction and printing should take a couple of hours at most. The results of five cases showed good alignment and proper function.
Three-dimensional technology can be applied in the everyday primary care treatment protocol of comminuted fractures as an in-house tool which greatly improves both functional and aesthetic outcomes.
颌骨粉碎性骨折是复杂的损伤,需要特别关注。过去,治疗方法包括使用颌间固定进行闭合复位。随着技术和固定系统的进步,切开复位成为一种普遍的选择。这些骨折在初次治疗阶段难以重建,因此导致更高的并发症发生率。三维(3D)规划和打印的引入带来了更好的效果,但由于需要外包规划和钛打印,这些主要集中在二次重建上。
在本报告中,我们描述了使用计算机辅助设计软件和3D熔融沉积打印机进行实时内部3D规划和打印,用于颌骨粉碎性骨折的虚拟复位和重建下颌骨的打印。
经过虚拟3D复位后,新创建的下颌骨进行了3D打印。然后使用该模型预弯重建板,该重建板又在手术期间用作复位骨段的模板。虚拟复位和打印过程最多需要几个小时。5例患者的结果显示对位良好且功能正常。
三维技术可作为一种内部工具应用于颌骨粉碎性骨折的日常初级治疗方案中,这极大地改善了功能和美学效果。