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Reconstruction of defects of maxillary sinus wall after removal of a huge odontogenic lesion using prebended 3D titanium-mesh and CAD/CAM technique
- Marcus Stoetzer†1,
- Majeed Rana†1Email author,
- Constantin von See1,
- André M Eckardt1 and
- Nils-Claudius Gellrich1
© Stoetzer et al; licensee BioMed Central Ltd. 2011
Received: 25 October 2011
Accepted: 9 November 2011
Published: 9 November 2011
A 63 year-old male with a huge odontogenic lesion of sinus maxillaris was treated with computer-assisted surgery. After resection of the odontogenic lesion, the sinus wall was reconstructed with a prebended 3D titanium-mesh using CAD/CAM technique. This work provides a new treatment device for maxillary reconstruction via rapid prototyping procedures.
Loss of hard and soft tissue structures of the midface due to resection of odontogenic lesions can be associated with substancial functional and aesthetic deficits . Conservative treatment due to simple resection and primary soft-tissue clouser will result in loss of soft and hard tissue support. Radical excision of tumor followed by adequate reconstruction can improve survival and provide more satisfactory functional and aesthetical outcome. Reconstruction of large maxillary defects following ablative surgery could be done by using vascularized bone transfer or, more often, primarily with simultaneous or delayed bone grafting . Another option for maxillary reconstruction might be the use of computer-assisted prebended titanium meshes, which acts as physical three dimensional supports of soft and hard tissue . Computer aided design/modeling (CAD/CAM) software that allows "mirroring" planning coupled to navigation systems has dramatically improved surgical strategies in reconstructive surgery of the craniomaxillofacial skeleton . A major challenge in planning procedures is that virtual reconstruction is based on a true-to-original reconstruction with a patient specific implant. In fact, application of commercially available 3D planning software in the clinical routine suffers from poor handling and an insufficient workflow. Since these systems do not represent a complete solution, they have to be supplemented by additional software and hardware devices.
The purpose of this technical note is to present a novel solution for computer-assisted planning of reconstruction of maxillary defects which is based on combination of user-friendly 3D planning software, iPlan 3.0, (Brainlab®, Feldkirchen, Germany) and a consistent physical design of predefined titanium mesh via rapid prototype modeling and CAD/CAM technique [5, 6].
Materials and methods
Results and Discussion
Many studies in oral and maxillofacial surgery have addressed the benefit of computer-assisted surgery in treatment of head and neck tumors [7, 8]. Image-guided tumor resection and reconstruction is a well-established procedure at our institution for complex craniofacial procedures. Based on our case, we could demonstrate that computer-assisted surgery is an eligible and precise method for treatment of huge odontogenic lesions of sinus maxillaris. Regarding the advantages of computer-assisted surgery, this technique will play a major part in craniofacial reconstructive surgery.
Conflict of interests statement
The authors declare that they have no competing interests.
Written informed consent was obtained from the patient for publication of this case report and accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal.
The article processing charges are funded by the Deutsche Forschungsgemeinschaft (DFG), "Open Acess Publizieren".
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