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Arienzo VP, Goldenberg DC, Noronha MAN, Lucas PFS, Ferreira BPV, de Oliveira TS. Robotic and Plastic Surgery: actuality and prospects for the near future, a scoping review. EINSTEIN-SAO PAULO 2024; 22:eRW0710. [PMID: 38747887 PMCID: PMC11081019 DOI: 10.31744/einstein_journal/2024rw0710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 01/04/2024] [Indexed: 05/19/2024] Open
Abstract
OBJECTIVE This work aims to review the existing use of robotics in plastic surgery. METHODS A meticulous selection process identified 22 articles relevant to this scoping review. RESULTS The literature on the use of robotics in plastic surgery is sparse. Nonetheless, this review highlights emerging benefits in microsurgery, breast reconstruction, and transoral surgery. CONCLUSION This scoping review identifies critical articles reporting the emerging use of robotics in plastic surgery. While the scientific medical community has yet to extensively document its use, the available evidence suggests a promising future for robotics in this field.
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Affiliation(s)
- Vitor Pelogi Arienzo
- Hospital Israelita Albert EinsteinSão PauloSPBrazil Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
| | - Dov Charles Goldenberg
- Hospital Israelita Albert EinsteinSão PauloSPBrazil Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
- Hospital das ClínicasFaculdade de MedicinaUniversidade de São PauloSão PauloSPBrazil Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
| | - Marcos Antonio Neves Noronha
- Hospital Israelita Albert EinsteinSão PauloSPBrazil Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
- Hospital das ClínicasFaculdade de MedicinaUniversidade de São PauloSão PauloSPBrazil Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
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Garajei A, Modarresi A, Arabkheradmand A, Shirkhoda M. Functional and esthetic outcomes of virtual surgical planning versus the conventional technique in mandibular reconstruction with a free fibula flap: A retrospective study of 24 cases. J Craniomaxillofac Surg 2024; 52:454-463. [PMID: 38448334 DOI: 10.1016/j.jcms.2024.01.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 10/26/2023] [Accepted: 01/16/2024] [Indexed: 03/08/2024] Open
Abstract
This study aimed to compare the functional and esthetic results in patients following mandibular reconstruction with a free fibula flap (FFF) by virtual surgical planning (VSP) versus the conventional technique. Patients who had undergone mandibular reconstruction with a FFF by VSP or the conventional technique were retrospectively assessed. The two groups were compared regarding functional and esthetic variables with appropriate scales preoperatively, intraoperatively, and postoperatively. Twenty-four patients were evaluated in two groups: conventional (n = 8) and VSP (n = 16). The mean amount of mandibular asymmetry was 2.62 mm (SD = 1.59) in the conventional group and 1.19 mm (SD = 1.32) in the VSP group. Of the patients who underwent conventional surgery, 12.5% had mandibular asymmetry of <2 mm and 87.5% had asymmetry of 2-5 mm. Of the VSP patients, 61.5% had mandibular asymmetry of <2 mm and 38.5% had mandibular asymmetry of 2-5 mm (p = 0.03). The mean difference in size of mandibular angle on the surgical and control sides was not significantly different between the two groups (p = 0.62). The difference in mean length of the mandibular body on the surgical side relative to the control side was not significant between the two groups (p = 0.75). Differences in functional variables between the two groups were not significant. Within the limitation of the study, it seems that the VSP technique resulted in better facial symmetry and superior esthetic outcomes compared with the conventional technique.
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Affiliation(s)
- Ata Garajei
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Department of Head and Neck Surgical Oncology and Reconstructive Surgery, Cancer Institute of Iran, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Modarresi
- Department of Oral and Maxillofacial Surgery, Craniomaxillofacial Research Center, Tehran Islamic Azad University of Medical Sciences, Dental Branch, Tehran, Iran.
| | - Ali Arabkheradmand
- Department of Surgery, Cancer Institute of Iran, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Shirkhoda
- Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran
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3
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Singh TS, Bhola N, Reche A. The Utility of 3D Printing for Surgical Planning and Patient-Specific Implant Design in Maxillofacial Surgery: A Narrative Review. Cureus 2023; 15:e48242. [PMID: 38054128 PMCID: PMC10695083 DOI: 10.7759/cureus.48242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 11/03/2023] [Indexed: 12/07/2023] Open
Abstract
Maxillofacial reconstructive implants are typically created in standard shapes and have a widespread application in head and neck surgery. During surgical procedures, the implant must be correctly bent according to the architecture of the particular bones. Bending takes practice, especially for untrained surgeons. Furthermore, repeated bending may increase internal stress, resulting in fatigue in vivo under masticatory loading and an array of consequences, including implant failure. There is a risk of fracture, screw loosening, and bone resorption. Resorption, infection, and displacement are usually associated with the use of premade alloplastic implants and autogenous grafts. Recent technological breakthroughs have led to the use of patient-specific implants (PSIs) developed by computer-designed additive manufacturing in reconstructive surgery. The use of computer-designed three-dimensional (3D)-printed PSI allows for more precise restoration of maxillofacial deformities, avoiding the common difficulties associated with premade implants and increasing patient satisfaction. Additive manufacturing is something that refers to a group of additive manufacturing methods. This technique has been quickly used in a variety of surgical procedures. The exponential expansion of this technology can be attributed to its enormous surgical value. Adding 3D printing to a medical practice can be a rewarding experience with stunning results.
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Affiliation(s)
- Tanvi S Singh
- Oral and Maxillofacial Surgery, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research (DMIHER), Wardha, IND
| | - Nitin Bhola
- Oral and Maxillofacial Surgery, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research (DMIHER), Wardha, IND
| | - Amit Reche
- Public Health Dentistry, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research (DMIHER), Wardha, IND
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Udayakumar SIV, Kwon D, Kwon TG, Paeng JY. Secondary healing property using Neoveil®, a polyglycolic acid bioabsorbable sheet on the oral mucosal defects. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2023; 124:101259. [PMID: 35940562 DOI: 10.1016/j.jormas.2022.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 07/24/2022] [Accepted: 08/04/2022] [Indexed: 10/16/2022]
Abstract
Neoveil® is a wound surface-covering agent composed of polyglycolic acid(PGA) effective for secondary healing. This study evaluated the secondary healing property of oral cavity mucosal defects using the PGA sheet. Thirty-four patients who underwent surgical excision of oral benign and malignant lesions, precancerous lesions, and tumors were evaluated. The PGA sheet was placed over the open wound to aid secondary healing. The defects were reviewed post-operatively for secondary healing, contracture, and secondary deformity. Male to female ratio was 20:14, and the mean age was 63.5 years. In all cases, the oral mucosal defect was present after the wide excision of the mucosal lesion. The PGA sheet was used as a surface covering agent which was found to be effective in secondary healing of the wound. Any side effects and adverse reactions which were caused by the PGA sheet was not evident. It can be used to avoid skin graft or free flap reconstruction or deformity from the direct closure in moderate size oral mucosal defect.
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Affiliation(s)
- Santhiya Iswarya Vinothini Udayakumar
- Department of Oral and Maxillofacial Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, Seoul, Republic of Korea
| | - Dohyun Kwon
- Department of Oral and Maxillofacial Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, Seoul, Republic of Korea
| | - Tae-Geon Kwon
- Department of Oral & Maxillofacial Surgery, School of Dentistry, Kyungpook National University, Daegu, Republic of Korea
| | - Jun-Young Paeng
- Department of Oral and Maxillofacial Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, Seoul, Republic of Korea.
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Kumar KPM, Varma S, Vipindas AP, Das Ajay T, Vinod A, Mullath A. Primary Reconstruction in Segmental Resection of Mandible-An Outcome Analysis of Different Reconstructive Techniques. Indian J Otolaryngol Head Neck Surg 2022; 74:6155-6163. [PMID: 36742643 PMCID: PMC9895505 DOI: 10.1007/s12070-021-02843-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 08/21/2021] [Indexed: 02/07/2023] Open
Abstract
Functional and cosmetic defects in the maxillofacial region may result from trauma, inflammatory disease, benign or malignant tumors. There are several well established reconstructive options for restoring mandibular continuity and function. Traditionally, surgeons have used their past experience to determine the best way to perform the osteotomy, graft harvesting, and graft shaping procedures for mandibular reconstruction. Focus has now shifted to optimize functional and aesthetic outcomes in mandible reconstruction. Refinements in surgical techniques continue to improve patient's quality of life. The purpose of this study was to evaluate the outcome of a range of reconstructive techniques in 20 patients who underwent segmental resection of mandible during the period 2004-2017.
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Affiliation(s)
- K. P. Manoj Kumar
- Department of Oral & Maxillofacial Surgery, KMCT Dental College, Kozhikode, Kerala India
| | - Sujatha Varma
- Department of Oral & Maxillofacial Surgery, KMCT Dental College, Kozhikode, Kerala India
| | - A. P. Vipindas
- Department of Oral & Maxillofacial Surgery, KMCT Dental College, Kozhikode, Kerala India
| | - T. Das Ajay
- Department of Oral & Maxillofacial Surgery, KMCT Dental College, Kozhikode, Kerala India
| | - Aswathi Vinod
- Department of Oral & Maxillofacial Surgery, KMCT Dental College, Kozhikode, Kerala India
| | - Aswin Mullath
- Department of Oral & Maxillofacial Surgery, KMCT Dental College, Kozhikode, Kerala India
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Steybe D, Poxleitner P, Metzger MC, Schmelzeisen R, Russe MF, Fuessinger MA, Brandenburg LS, Voss PJ, Schlager S. Analysis of the accuracy of computer‐assisted
DCIA
flap mandibular reconstruction applying a novel approach based on geometric morphometrics. Head Neck 2022; 44:2810-2819. [DOI: 10.1002/hed.27196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 07/27/2022] [Accepted: 08/31/2022] [Indexed: 11/06/2022] Open
Affiliation(s)
- David Steybe
- Department of Oral and Maxillofacial Surgery, Medical Center – University of Freiburg, Faculty of Medicine University of Freiburg Freiburg Germany
| | - Philipp Poxleitner
- Department of Oral and Maxillofacial Surgery, Medical Center – University of Freiburg, Faculty of Medicine University of Freiburg Freiburg Germany
| | - Marc C. Metzger
- Department of Oral and Maxillofacial Surgery, Medical Center – University of Freiburg, Faculty of Medicine University of Freiburg Freiburg Germany
| | - Rainer Schmelzeisen
- Department of Oral and Maxillofacial Surgery, Medical Center – University of Freiburg, Faculty of Medicine University of Freiburg Freiburg Germany
| | - Maximilian F. Russe
- Department of Diagnostic and Interventional Radiology Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg Freiburg Germany
| | - Marc Anton Fuessinger
- Department of Oral and Maxillofacial Surgery, Medical Center – University of Freiburg, Faculty of Medicine University of Freiburg Freiburg Germany
| | - Leonard S. Brandenburg
- Department of Oral and Maxillofacial Surgery, Medical Center – University of Freiburg, Faculty of Medicine University of Freiburg Freiburg Germany
| | - Pit J. Voss
- Department of Oral and Maxillofacial Surgery, Medical Center – University of Freiburg, Faculty of Medicine University of Freiburg Freiburg Germany
| | - Stefan Schlager
- Department of Oral and Maxillofacial Surgery, Medical Center – University of Freiburg, Faculty of Medicine University of Freiburg Freiburg Germany
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7
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Mao Y, Xu Z, He Z, Wang J, Zhu Z. Wet-adhesive materials of oral and maxillofacial region: From design to application. CHINESE CHEM LETT 2022. [DOI: 10.1016/j.cclet.2022.04.059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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8
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Evaluation of the Proximal Tibia as a Donor Site of Cancellous Bone for Intraoral Grafting Procedures-A Retrospective Study. J Clin Med 2022; 11:jcm11061493. [PMID: 35329821 PMCID: PMC8953495 DOI: 10.3390/jcm11061493] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 03/02/2022] [Accepted: 03/07/2022] [Indexed: 02/01/2023] Open
Abstract
Background: Autogenous bone grafts remain the “gold standard” in maxillofacial reconstructive procedures. The objective of this study was to evaluate the proximal tibia as a donor site of cancellous bone for bone grafting procedures of the mandible on the basis of intraoperative parameters and clinical observations. Methods: The study was based on a medical record search of 40 patients who underwent surgical procedures because of benign pathological lesions of the jaws resulting in 3-wall bone defects of the mandible and qualified for surgical removal of the lesion with simultaneous bone grafting of the defect with autogenous cancellous bone harvested from the proximal tibia. Results: The use of the proximal tibia for bone grafting procedures enables large amounts of cancellous bone (15.09 cc in average) to be obtained. The procedure is characterized by a low risk of early and late complications, which include excessive bleeding, wound infection, lengthy healing time, scars, a loss of sensation around the scars, aching, a dip in bone, swelling and tenderness. Conclusions: The ability to obtain large amounts of cancellous bone and a low risk of intra- and postoperative complications make the proximal tibia an attractive donor site for the bone grafting procedures in maxillofacial surgery.
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Rifai A, Houshyar S, Fox K. Progress towards 3D-printing diamond for medical implants: A review. ANNALS OF 3D PRINTED MEDICINE 2021. [DOI: 10.1016/j.stlm.2020.100002] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
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10
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Memon AR, Li D, Hu J, Wang E, Zhang D, Chen X. The development of computer-aided patient-specific template design software for 3D printing in cranio-maxillofacial surgery. Int J Med Robot 2021; 17:e2243. [PMID: 33580624 DOI: 10.1002/rcs.2243] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 02/05/2021] [Accepted: 02/08/2021] [Indexed: 01/06/2023]
Abstract
BACKGROUND The patient-specific templates for osteotomy often have complex surface features. Using current commercial software to design such templates is quite complicated, tedious and unrepeatable. AIMS In this study, a novel surgical planning system for oral and maxillofacial surgery named EasyTemplate is developed, aiming to help doctors shorten the modelling time and assure the reliability in template design. MATERIALS & METHODS In the simplified design process of an osteotomy guide, the main template can be formed efficiently using a surface offsetting algorithm, which is based on isosurface extraction and oriented bounding box. Thereafter, the cutting grooves can be generated automatically. RESULTS A complicated surgical guide could be built accurately in about 10 min. Clinical orthognathic cases were conducted successfully using osteotomy and repositioning templates designed by EasyTemplate. DISCUSSION Compared with commercially available softwares, higher efficiency and simpler design process were achieved, moreover, the time cost is one-third or even less. CONCLUSION EasyTemplate can be a useful alternative to traditional softwares. This software allows the auto-generation algorithm which helps avoid a tedious modeling process while providing basic shapes for designers.
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Affiliation(s)
- Afaque R Memon
- School of Mechanical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Dongyuan Li
- School of Mechanical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Junlei Hu
- School of Mechanical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Enpeng Wang
- School of Mechanical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Dingzhong Zhang
- School of Mechanical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Xiaojun Chen
- School of Mechanical Engineering, Shanghai Jiao Tong University, Shanghai, China.,Institute of Medical Robotics, Shanghai Jiao Tong University, Shanghai, China.,Engineering Research Center of Digital Medicine and Clinical Translation, Ministry of Education, Shanghai, China
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11
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Xu C, Lin L, Aung ZM, Chen X, Sun M, Chai G, Xie L. A Preliminary Study on Animal Experiments of Robot-Assisted Craniotomy. World Neurosurg 2021; 149:e748-e757. [PMID: 33540095 DOI: 10.1016/j.wneu.2021.01.108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Revised: 01/21/2021] [Accepted: 01/22/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND Traditional craniotomy relies on the surgeon's experience and can be complicated owing to excessive skull bone removal, undesirable brain tissue penetration, or severe bleeding. For craniotomy, we developed a robot system based on intraoperative cone-beam computed tomography image guidance and human-robot cooperative interaction, aiming to improve the safety and accuracy of surgery and reduce the labor-intensiveness of the procedure. METHODS Intraoperative cone-beam computed tomography image guidance was adopt to improve the accuracy in our experiment. Craniotomy was performed using an interactive method based on human-robot collaboration, which could achieve a natural interactive method in accordance with surgeons' operating habits. The frequency-based method of contact distinction and the method of torque estimation were used to improve the safety of the designed robot. RESULTS An animal experiment was conducted to verify the effectiveness of the robot system. During the drilling process, the position error was 0.92 ± 0.17 mm (upper surface) and 0.97 ± 0.11 mm (lower surface), and the angle error was 3.37 ± 1.43°. During the milling process, the position error was 1.06 ± 0.13 mm (upper surface) and 1.09 ± 0.09 mm (lower surface). The results showed that the system had sufficient precision and could better complete craniotomy with human-robot collaboration. In addition, with the feedback of multisensor information, the robot system could achieve a sufficient level of safety. CONCLUSIONS The robot system can achieve accurate positioning and safe user-friendly human-robot interaction, which solves problems encountered in the drilling and milling of craniotomy, meets clinical needs, and provides a new method for robot-assisted craniotomy.
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Affiliation(s)
- Cheng Xu
- Institute of Forming Technology & Equipment, Shanghai, China
| | - Li Lin
- Institute of Forming Technology & Equipment, Shanghai, China
| | - Zin Mar Aung
- Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaojun Chen
- Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Mengzhe Sun
- Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Gang Chai
- Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Le Xie
- Institute of Forming Technology & Equipment, Shanghai, China; Institute of Medical Robotics, Shanghai Jiao Tong University, Shanghai, China.
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12
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Meng FH, Zhu ZH, Lei ZH, Zhang XH, Shao L, Zhang HZ, Zhang T. Feasibility of the application of mixed reality in mandible reconstruction with fibula flap: A cadaveric specimen study. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2021; 122:e45-e49. [PMID: 33434746 DOI: 10.1016/j.jormas.2021.01.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 12/02/2020] [Accepted: 01/04/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND In recent years, a new technology, mixed reality (MR), has emerged and surpassed the limitations of augmented reality (AR) with its inability to interact with hologram. This study aimed to investigate the feasibility of the application of MR in mandible reconstruction with fibula flap. METHODS Computed tomography (CT) examination was performed for one cadaveric mandible and ten fibula bones. Using professional software Proplan CMF 3.0 (Materialize, Leuven, Belgium), we created a defected mandibular model and simulated the reconstruction design with these 10 fibula bones. The surgical plans were transferred to the HoloLens. We used HoloLens to guide the osteotomy and shaping of the fibular bone. After fixing the fibular segments using the Ti template, all segments underwent a CT examination. Before and after objects were compared for measurements of the location of fibular osteotomies, angular deviation of fibular segments, and intergonial angle distances. RESULTS The mean location of the fibular osteotomies, angular deviation of the fibular segments, and intergonial angle distances were 2.11 ± 1.31 mm, 2.85°± 1.97°, and 7.24 ± 3.42 mm, respectively. CONCLUSION The experimental results revealed that slight deviations remained in the accuracy of fibular osteotomy. With the further development of technology, it has the potential to improve the efficiency and precision of the reconstructive surgery.
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Affiliation(s)
- F H Meng
- Chinese PLA General Hospital, Department of Oral and Maxillofacial Surgery, 100853, Beijing, China
| | - Z H Zhu
- Peking Union Medical College Hospital, Department of Oral and Maxillofacial Surgery, 100730, Beijing, China
| | - Z H Lei
- Peking Union Medical College Hospital, Department of Oral and Maxillofacial Surgery, 100730, Beijing, China
| | - X H Zhang
- Shenzhen Luohu Hospital Group Luohu People's Hospital, Department of Oral and Maxillofacial Surgery, 518020, Shenzhen, China
| | - L Shao
- Beijing Institute of Technology, Optoelectronic College, 100081, Beijing, China
| | - H Z Zhang
- Chinese PLA General Hospital, Department of Oral and Maxillofacial Surgery, 100853, Beijing, China.
| | - T Zhang
- Peking Union Medical College Hospital, Department of Oral and Maxillofacial Surgery, 100730, Beijing, China.
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Pucci R, Weyh A, Smotherman C, Valentini V, Bunnell A, Fernandes R. Accuracy of virtual planned surgery versus conventional free-hand surgery for reconstruction of the mandible with osteocutaneous free flaps. Int J Oral Maxillofac Surg 2020; 49:1153-1161. [DOI: 10.1016/j.ijom.2020.02.018] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Revised: 01/13/2020] [Accepted: 02/27/2020] [Indexed: 01/08/2023]
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14
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Piotrowski SL, Wilson L, Dharmaraj N, Hamze A, Clark A, Tailor R, Hill LR, Lai S, Kasper FK, Young S. Development and Characterization of a Rabbit Model of Compromised Maxillofacial Wound Healing. Tissue Eng Part C Methods 2020; 25:160-167. [PMID: 30747042 PMCID: PMC6457326 DOI: 10.1089/ten.tec.2018.0361] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
IMPACT STATEMENT Maxillofacial defects often present the clinical challenge of a compromised wound bed. Preclinical evaluation of tissue engineering techniques developed to facilitate healing and reconstruction typically involves animal models with ideal wound beds. The healthy wound bed scenario does not fully mimic the complex clinical environment in patients, which can lead to technology failure when translating from preclinical in vivo research to clinical use. The reported preclinical animal model of compromised wound healing enables investigation of tissue engineering technologies in a more clinically relevant scenario, potentially fostering translation of promising results in preclinical research to patients.
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Affiliation(s)
- Stacey L Piotrowski
- 1 Department of Oral and Maxillofacial Surgery, School of Dentistry, The University of Texas Health Science Center, Houston, Texas.,2 Center for Laboratory Animal Medicine and Care, The University of Texas Health Science Center, Houston, Texas.,3 Department of Veterinary Medicine and Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Lindsay Wilson
- 1 Department of Oral and Maxillofacial Surgery, School of Dentistry, The University of Texas Health Science Center, Houston, Texas
| | - Neeraja Dharmaraj
- 1 Department of Oral and Maxillofacial Surgery, School of Dentistry, The University of Texas Health Science Center, Houston, Texas
| | - Amani Hamze
- 1 Department of Oral and Maxillofacial Surgery, School of Dentistry, The University of Texas Health Science Center, Houston, Texas
| | - Ashley Clark
- 4 Department of Diagnostic and Biomedical Sciences, School of Dentistry, The University of Texas Health Science Center, Houston, Texas
| | - Ramesh Tailor
- 5 Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Lori R Hill
- 3 Department of Veterinary Medicine and Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Stephen Lai
- 6 Division of Surgery, Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - F Kurtis Kasper
- 7 Department of Orthodontics, School of Dentistry, Graduate School of Biomedical Sciences, The University of Texas Health Science Center, Houston, Texas
| | - Simon Young
- 1 Department of Oral and Maxillofacial Surgery, School of Dentistry, The University of Texas Health Science Center, Houston, Texas
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15
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Virtual Surgical Planning for Successful Second-Stage Mandibular Defect Reconstruction Using Vascularized Iliac Crest Bone Flap: A Valid and Reliable Method. Ann Plast Surg 2019; 84:183-187. [PMID: 31800546 DOI: 10.1097/sap.0000000000002102] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE Second-stage reconstruction of mandibular defects faces problems of anatomic disorder and bone displacement due to tumor resection. As a newer technique, virtual surgical planning (VSP) may help to increase the accuracy and efficiency of the complicated reconstruction. This study aims to evaluate the application of VSP and splint-guided surgery in second-stage mandibular reconstruction using vascularized iliac crest bone flap. METHODS Between October 2016 and February 2018, 5 patients (3 men and 2 women) with mandibular defects of duration between 8 months and 8 years underwent VSP-aided secondary reconstruction in the School and Hospital of Stomatology of Wuhan University (Wuhan, China). Virtual surgical planning was performed and serial guiding splints were printed to replicate the design into the actual operation. The linear and 3-dimensional deviations after surgery were analyzed. Patient complications and feedback were recorded during follow up. RESULTS All 5 patients underwent successful reconstruction using vascularized iliac crest bone flap. No serious donor sites or recipient site complications were observed after 10- to 28-month follow-up. In comparison with the presurgery designs, the linear deviations in coronal plane were 2.7 ± 0.4 mm (range, -2.2 to 3.9 mm) in measurements from the condylar head to the condylar head and 0.70 ± 0.6 mm (range, -0.1 to 1.7 mm) from the gonial angle to the gonial angle, and that in sagittal plane was 2.4 ± 0.88 mm (range, -3 to 4.4 mm) from the anterior inferior mandibular border to the center point on the condylar head to the condylar head line. The whole 3-dimensional deviation was 1.2 ± 1.7 mm in all patients. CONCLUSION Well-designed splints can assist in precise mandibular reconstruction with high efficiency and accuracy, and thus are a reliable method for complicated second-stage mandibular reconstruction. However, to achieve a better outcome, a satisfactory design is required to adapt the complicated and varied defect.
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Powcharoen W, Yang WF, Yan Li K, Zhu W, Su YX. Computer-Assisted versus Conventional Freehand Mandibular Reconstruction with Fibula Free Flap. Plast Reconstr Surg 2019; 144:1417-1428. [DOI: 10.1097/prs.0000000000006261] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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Dahake S, Kuthe A, Mawale M, Sapkal P, Bagde A, Daronde S, Kamble M, Sarode B. Development of customized implant and customized surgical osteotomy guide in ablative tumor surgery for accurate mandibular reconstruction. Int J Med Robot 2019; 16:e2046. [PMID: 31675463 DOI: 10.1002/rcs.2046] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 09/03/2019] [Accepted: 09/26/2019] [Indexed: 11/07/2022]
Abstract
OBJECTIVES The objective of this study was to provide the generalized methodology for design and development of a customized implant and customized surgical osteotomy guide (CSOG) for precise mandibular tumor resection and placement of a customized implant in ablative tumor surgery for accurate mandibular reconstruction. METHODS Medical imaging technique, image processing, virtual surgical planning (VSP), biomedical computer-aided design (CAD), and rapid prototyping (RP) were used to develop CSOG and customized implant. A mock surgical test and an experimental analysis were performed on the biomodel (RP assisted diseased model) to check the effectiveness of the CSOG. RESULTS The paired t test showed the statistically significant result with the use of CSOG as compared to the without using CSOG in ablative mandibular tumor surgery. CONCLUSIONS A mock test and an experimental analysis proved that, the precise tumor resection and customized implant placement with minimal gap between bone-implant junctions in mandibular reconstruction using CSOG.
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Affiliation(s)
- Sandeep Dahake
- Department of Mechanical Engineering, Visvesvaraya National Institute of Technology, Nagpur, India
| | - Abhaykumar Kuthe
- Department of Mechanical Engineering, Visvesvaraya National Institute of Technology, Nagpur, India
| | - Mahesh Mawale
- Department of Mechanical Engineering, Kavikulguru Institute of Technology and Science, Ramtek, India
| | - Pranav Sapkal
- Department of Mechanical Engineering, Visvesvaraya National Institute of Technology, Nagpur, India
| | - Ashutosh Bagde
- Department of Mechanical Engineering, Visvesvaraya National Institute of Technology, Nagpur, India
| | - Subodh Daronde
- Department of Mechanical Engineering, Visvesvaraya National Institute of Technology, Nagpur, India
| | - Manish Kamble
- Department of Mechanical Engineering, Visvesvaraya National Institute of Technology, Nagpur, India
| | - Bhupesh Sarode
- Department of Mechanical Engineering, Visvesvaraya National Institute of Technology, Nagpur, India
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Blanc J, Fuchsmann C, Nistiriuc-Muntean V, Jacquenot P, Philouze P, Ceruse P. Evaluation of virtual surgical planning systems and customized devices in fibula free flap mandibular reconstruction. Eur Arch Otorhinolaryngol 2019; 276:3477-3486. [DOI: 10.1007/s00405-019-05625-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2019] [Accepted: 08/29/2019] [Indexed: 11/30/2022]
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Rifai A, Tran N, Reineck P, Elbourne A, Mayes E, Sarker A, Dekiwadia C, Ivanova EP, Crawford RJ, Ohshima T, Gibson BC, Greentree AD, Pirogova E, Fox K. Engineering the Interface: Nanodiamond Coating on 3D-Printed Titanium Promotes Mammalian Cell Growth and Inhibits Staphylococcus aureus Colonization. ACS APPLIED MATERIALS & INTERFACES 2019; 11:24588-24597. [PMID: 31199619 DOI: 10.1021/acsami.9b07064] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Additively manufactured selective laser melted titanium (SLM-Ti) opens the possibility of tailored medical implants for patients. Despite orthopedic implant advancements, significant problems remain with regard to suboptimal osseointegration at the interface between the implant and the surrounding tissue. Here, we show that applying a nanodiamond (ND) coating onto SLM-Ti scaffolds provides an improved surface for mammalian cell growth while inhibiting colonization of Staphylococcus aureus bacteria. Owing to the simplicity of our methodology, the approach is suitable for coating SLM-Ti geometries. The ND coating achieved 32 and 29% increases in cell density of human dermal fibroblasts and osteoblasts, respectively, after 3 days of incubation compared with the uncoated SLM-Ti substratum. This increase in cell density complements an 88% reduction in S. aureus detected on the ND-coated SLM-Ti substrata. This study paves a way to create facile antifouling SLM-Ti structures for biomedical implants.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Takeshi Ohshima
- National Institutes for Quantum and Radiological Science and Technology , Takasaki , Gunma 370-1292 , Japan
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Clinical Application of Temporary External Fixator for Immediate Mandibular Reconstruction. J Craniofac Surg 2019; 30:e337-e342. [PMID: 31166279 DOI: 10.1097/scs.0000000000005303] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Immediate mandibular reconstruction is always necessary for the patients receiving segmental mandibulectomy to recover the facial contour and function of occlusion. When 3D modeling is unavailable, temporary external fixator is necessary to maintain the occlusion relationship and facial contour. In this study, we introduce the clinical application of temporary external fixator for immediate mandibular reconstruction in patients receiving segmental mandibulectomy, which consists of 2 anchor claws, 2 all-round retentive arms, and 1 central locking structure. From August 2016 to September 2017, temporary external fixator was applied in 13 patients. Clinical data of gender, age, surgical procedure, duration of operation, and clinical outcomes were recorded and analyzed. Among the 13 patients, there were 4 men and nine women whose ages ranged from 21 to 64 (mean 47.7) years old. There were 9 benign and 4 malignant lesions. All lesions expended at the buccal side of mandible. 12 fibular flaps and 1 vascularized iliac bone graft were used. The mandibular defect ranged from 6 to 14 (mean 10) cm. The operation duration of surgery ranged from 5 to 10 (mean 7) hours. All flaps survived with primary healing. The occlusion and facial contour were good, without significant changes of the length of mandibular body and width of mandible before and after surgery. No functional sequelae were noted at the donor sites. From these results, the temporary external fixator is easy to operate; the surgical procedure is simple and time-saving for surgeon when 3D modeling is unavailable. The indication for temporary external fixator usage is the mandibular lesion growing outward to cheek soft tissue.
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Ma Q, Kobayashi E, Wang J, Hara K, Suenaga H, Sakuma I, Masamune K. Development and preliminary evaluation of an autonomous surgical system for oral and maxillofacial surgery. Int J Med Robot 2019; 15:e1997. [PMID: 30900789 DOI: 10.1002/rcs.1997] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Revised: 02/27/2019] [Accepted: 03/06/2019] [Indexed: 11/12/2022]
Abstract
BACKGROUND Human-related factors affect the accuracy and safety of the oral and maxillofacial surgery (OMS). This study proposed an autonomous surgical system aiming to conduct the OMS under the assistance and surveillance of the surgeon. METHODS A markerless navigation module and a compact OMS robot were seamlessly integrated into this system. The specifications of each module and the working concept of the system were elaborated in this paper. A drilling experiment was conducted on five 3D-printed mandible models to test the pose detecting capability and evaluate the operational performance. RESULTS The experiment showed that this system could successfully guide the robot finishing the operation regardless of the mandible pose. The accuracy of software and hardware are acceptable and potential performance improvement can be achieved in positioning accuracy. CONCLUSION This system proposed a novel concept and a practical solution to decrease the human-related factors on the OMS, which may change the role of the surgeon in the future operating room and finally benefit the outcomes of OMS.
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Affiliation(s)
- Qingchuan Ma
- Graduate School of Engineering, The University of Tokyo, Tokyo, Japan
| | - Etsuko Kobayashi
- Institute of Advanced BioMedical Engineering and Science, Tokyo Women's Medical University, Tokyo, Japan
| | - Junchen Wang
- School of Mechanical Engineering and Automation, Beihang University, Beijing, China
| | - Kazuaki Hara
- Graduate School of Engineering, The University of Tokyo, Tokyo, Japan
| | - Hideyuki Suenaga
- Department of Oral-Maxillofacial Surgery and Orthodontics, The University of Tokyo Hospital, Tokyo, Japan
| | - Ichiro Sakuma
- Graduate School of Engineering, The University of Tokyo, Tokyo, Japan
| | - Ken Masamune
- Institute of Advanced BioMedical Engineering and Science, Tokyo Women's Medical University, Tokyo, Japan
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Mohanty R, Singh V. An analysis of approach toward oral and maxillofacial surgery: A survey of 1800 health-care specialists, students, and general people in Odisha, India. Natl J Maxillofac Surg 2019; 10:68-72. [PMID: 31205391 PMCID: PMC6563626 DOI: 10.4103/njms.njms_76_18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Aim: The aim of the study is to assess the perception of oral and maxillofacial surgery (OMFS) by health-care professionals, students, and general public in the state of Odisha, India. Materials and Methods: A questionnaire form was formatted that listed ten clinical situations and given by hand to 1800 individuals, divided into six groups: Group I – general medical practitioners; Group II – specialties of dentistry; Group III – general dental practitioners; Group IV – medical students; Group V – dental students; and Group VI – general public, each comprising 300 individuals. Respondents were asked to indicate who they would expect to treat them if they had one of the specified conditions listed in the questionnaire. We present the results and current awareness levels of this simple questionnaire and in due course educate and inform the society about the treatment OMFS provides. Results: Most of the respondents in Groups II, III, and V agreed that specific conditions listed in the questionnaire were within the domain of OMFS, but such response was not seen in Groups I, IV, and VI (P < 0.05). An overall awareness level of OMFS was found to be 50.8%. Conclusion: The liability and responsibility of creating and improving the awareness and perception of our specialty lies on oral and maxillofacial surgeon. Unified efforts at individual as well as global level will help achieve this goal.
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Affiliation(s)
- Rajat Mohanty
- Department of Oral and Maxillofacial Surgery, Kalinga Institute of Dental Sciences, KIIT University, Bhubaneswar, Odisha, India
| | - Vaibhav Singh
- Department of Head and Neck Cancer Surgery, Narayana Superspeciality Hospital, Kolkata, West Bengal, India
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Vadepally AK, Sinha R. What Surgical Education the Speciality Offers? Perception of Role of Oral and Maxillofacial Surgery by 1200 Healthcare Professionals, Students and the General Public in Hyderabad, India. J Maxillofac Oral Surg 2017; 17:182-187. [PMID: 29618883 DOI: 10.1007/s12663-017-1050-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Accepted: 10/04/2017] [Indexed: 11/28/2022] Open
Abstract
Aim To investigate the perception of Oral and maxillofacial surgery by healthcare professionals, students and general public. Materials and Methods A questionnaire form was created that listed ten clinical situations, and given by hand to 1200 individuals, divided into six groups: group 1, medical professionals; group 2, Specialties of dentistry; group 3, general dentists; group 4, medical students; group 5, dental students; and group 6, general public, each comprising 200 individuals. Respondents were asked to indicate who they would expect to treat them if they had one of the specified conditions listed in the questionnaire. We present the results and current awareness levels of this simple questionnaire. The present study addresses the common issue raised by many authors, 'What surgical education the speciality offers?' especially to medical professionals, medical students and general public to enhance an appropriate referral. Results Most of the respondents in groups 2, 3 and 5 agreed that specific conditions listed in the questionnaire were within the domain of oral and maxillofacial surgery, but such response was not seen in groups 1, 4 and 6 (p < 0.001). An overall awareness level of oral and maxillofacial surgery was found to be 50.2%. Conclusion The onus of creating and improving the awareness and perception of our specialty lies on oral and maxillofacial surgeon. Unified efforts at individual as well as global level will help achieve this goal.
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Affiliation(s)
- Ashwant Kumar Vadepally
- Department of Oral and Maxillofacial Surgery, Sri Sai Collage of Dental Surgery, Vikarabad, Telangana India
| | - Ramen Sinha
- 2Department of Oral and Maxillofacial Surgery, Sri Sai College of Dental Surgery, Vikarabad, Telangana India
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Abstract
There is a recognized need to reconstruct and restore complex craniomaxillofacial soft tissues. The objective of this article is to focus on the role that tissue engineering/regenerative medicine can play in addressing various barriers (vascularity, tissue bulk, volitional control, and esthetics) and impediments (timing, regional applicability/dissemination, and regulation by the US Food and Drug Administration) to optimal tissue reconstruction of complex soft tissue structures. We will use the lips as an example to illustrate our points.
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Affiliation(s)
- Roderick Youngdo Kim
- Department of Oral & Maxillofacial Surgery, University of Michigan Health System, Towsley Center Rm G1114, 1515 East Medical Center Drive, Ann Arbor, MI 48109-5222, USA
| | - Sam Seoho Bae
- Department of Oral & Maxillofacial Surgery, University of Michigan Health System, Towsley Center Rm G1114, 1515 East Medical Center Drive, Ann Arbor, MI 48109-5222, USA
| | - Stephen Elliott Feinberg
- Department of Oral & Maxillofacial Surgery, University of Michigan Health System, Towsley Center Rm G1114, 1515 East Medical Center Drive, Ann Arbor, MI 48109-5222, USA.
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Wang Y, Zhang H, Fan S, Zhang D, Huang Z, Chen W, Ye J, Li J. Mandibular reconstruction with the vascularized fibula flap: comparison of virtual planning surgery and conventional surgery. Int J Oral Maxillofac Surg 2016; 45:1400-1405. [DOI: 10.1016/j.ijom.2016.06.015] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Revised: 03/22/2016] [Accepted: 06/21/2016] [Indexed: 10/21/2022]
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Wu J, Sun J, Shen SG, Xu B, Li J, Zhang S. Computer-assisted navigation: its role in intraoperatively accurate mandibular reconstruction. Oral Surg Oral Med Oral Pathol Oral Radiol 2016; 122:134-42. [DOI: 10.1016/j.oooo.2016.02.001] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2015] [Revised: 01/12/2016] [Accepted: 02/02/2016] [Indexed: 10/22/2022]
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Microvascular medial femoral condylar flaps in 107 consecutive reconstructions in the head and neck. Br J Oral Maxillofac Surg 2016; 54:614-8. [DOI: 10.1016/j.bjoms.2016.03.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2015] [Accepted: 03/09/2016] [Indexed: 11/22/2022]
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Quan C, Zhigang C, Xin P, Yang W, Chuanbin G. Potential new method of design for reconstruction of complicated mandibular defects: a virtual deformable mandibular model. Br J Oral Maxillofac Surg 2015; 54:170-5. [PMID: 26711316 DOI: 10.1016/j.bjoms.2015.11.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Accepted: 11/28/2015] [Indexed: 10/22/2022]
Abstract
The treatment of complicated mandibular defects, including misshaped and missing bones, is challenging, and the success of reconstruction depends to a large extent on the formulation of a precise surgical plan. There is still no ideal preoperative method of design for reconstruction to deal with large, cross-midline, mandibular, segmental defects. We have built a virtual deformable mandibular model (VDMM) with 3-dimensional animation software. Sixteen handles were set on the model, and these could be easily controlled with a computer mouse to change the morphology of the deformable mandibular model. The computed tomographic (CT) data from 10 normal skulls was used to validate the adjustability of the VDMM. According to the positions of the mandibular fossa of the temporomandibular joint, the maxillary dental arch, and the craniomaxillofacial profile, the model could be adjusted to an ideal contour, which was coordinated with the skull. The VDMM was then adjusted further according to the morphology of the original mandible. A 3-dimensional comparison was made between the model of the deformed mandible and the original mandible. Using 16 control handles, the VDMM could be adjusted to a new outline, which was similar in shape to the original mandible. Within 3mm deviation either way, the absolute mean distribution of deviation between the contour of the deformed model and the original mandible was 92.5%. The VDMM might be useful for preoperative design of reconstruction of complicated mandibular defects.
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Affiliation(s)
- Chen Quan
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology
| | - Cai Zhigang
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology
| | - Peng Xin
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology
| | - Wang Yang
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology
| | - Guo Chuanbin
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology.
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An integrated system for planning, navigation and robotic assistance for mandible reconstruction surgery. INTEL SERV ROBOT 2015. [DOI: 10.1007/s11370-015-0189-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Miyawaki A, Hijioka H, Ishida T, Nozoe E, Nakamura N, Oya R. Intraoperative frozen section histological analysis of resection samples is useful for the control of primary lesions in patients with oral squamous cell carcinoma. Mol Clin Oncol 2014; 3:55-62. [PMID: 25469270 DOI: 10.3892/mco.2014.409] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Accepted: 08/22/2014] [Indexed: 12/28/2022] Open
Abstract
To ensure reliable surgical margins, intraoperative frozen section histological analysis (FS) has been performed since October, 2005 as follows: i) the orientation at the anatomical position and extent of the tumor are shared between oral pathologists and oral surgeons using imaging evaluations and pathological pictures and the planned site of sampling for intraoperative FS is confirmed; ii) a tumor team is organized and the team marks the tumor area and sets the resection range to correct the setting errors of the resection range among operators; iii) vital Lugol staining is applied to the lesion prior to tumor resection, the surgical margin is set based on the non-stained region and the extent of the tumor is macroscopically confirmed in the maximum cross-sectional surface of the resected specimen; and iv) FS is performed using samples from resected specimens to confirm the mucoepithelium and safety margin of the deep stump. The aim of this study was to evaluate the usefulness of our FS method. The treatment outcomes of oral squamous cell carcinoma were retrospectively investigated in patients treated prior to (Group 1) and after (Group 2) the introduction of our FS method. The recurrence rate of the primary lesions was high (17.3%) in Group 1, but decreased significantly in Group 2 (6.9%). Regarding clinicopathological factors, the condition of the surgical margins was associated with recurrence of the primary lesion in Group 1, but not in Group 2. In conclusion, our FS method appears to be useful for resecting tumors with reliable safety margins.
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Affiliation(s)
- Akihiko Miyawaki
- Department of Oral and Maxillofacial Surgery, University Hospital of Occupational and Environmental Health, Kitakyushu, Fukuoka 807-8556, Japan
| | - Hiroshi Hijioka
- Department of Oral and Maxillofacial Surgery, Field of Oral and Maxillofacial Rehabilitation, Advanced Therapeutics Course, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Kagoshima 890-8520, Japan
| | - Takayuki Ishida
- Department of Oral and Maxillofacial Surgery, Field of Oral and Maxillofacial Rehabilitation, Advanced Therapeutics Course, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Kagoshima 890-8520, Japan
| | - Etsuro Nozoe
- Department of Oral and Maxillofacial Surgery, Field of Oral and Maxillofacial Rehabilitation, Advanced Therapeutics Course, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Kagoshima 890-8520, Japan
| | - Norifumi Nakamura
- Department of Oral and Maxillofacial Surgery, Field of Oral and Maxillofacial Rehabilitation, Advanced Therapeutics Course, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Kagoshima 890-8520, Japan
| | - Ryoichi Oya
- Department of Oral and Maxillofacial Surgery, University Hospital of Occupational and Environmental Health, Kitakyushu, Fukuoka 807-8556, Japan
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Liu YF, Xu LW, Zhu HY, Liu SSY. Technical procedures for template-guided surgery for mandibular reconstruction based on digital design and manufacturing. Biomed Eng Online 2014; 13:63. [PMID: 24886431 PMCID: PMC4049493 DOI: 10.1186/1475-925x-13-63] [Citation(s) in RCA: 74] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2014] [Accepted: 05/17/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The occurrence of mandibular defects caused by tumors has been continuously increasing in China in recent years. Conversely, results of the repair of mandibular defects affect the recovery of oral function and patient appearance, and the requirements for accuracy and high surgical quality must be more stringent. Digital techniques--including model reconstruction based on medical images, computer-aided design, and additive manufacturing--have been widely used in modern medicine to improve the accuracy and quality of diagnosis and surgery. However, some special software platforms and services from international companies are not always available for most of researchers and surgeons because they are expensive and time-consuming. METHODS Here, a new technical solution for guided surgery for the repair of mandibular defects is proposed, based on general popular tools in medical image processing, 3D (3 dimension) model reconstruction, digital design, and fabrication via 3D printing. First, CT (computerized tomography) images are processed to reconstruct the 3D model of the mandible and fibular bone. The defect area is then replaced by healthy contralateral bone to create the repair model. With the repair model as reference, the graft shape and cutline are designed on fibular bone, as is the guide for cutting and shaping. The physical model, fabricated via 3D printing, including surgical guide, the original model, and the repair model, can be used to preform a titanium locking plate, as well as to design and verify the surgical plan and guide. In clinics, surgeons can operate with the help of the surgical guide and preformed plate to realize the predesigned surgical plan. RESULTS With sufficient communication between engineers and surgeons, an optimal surgical plan can be designed via some common software platforms but needs to be translated to the clinic. Based on customized models and tools, including three surgical guides, preformed titanium plate for fixation, and physical models of the mandible, grafts for defect repair can be cut from fibular bone, shaped with high accuracy during surgery, and fixed with a well-fitting preformed locking plate, so that the predesigned plan can be performed in the clinic and the oral function and appearance of the patient are recovered. This method requires 20% less operating time compared with conventional surgery, and the advantages in cost and convenience are significant compared with those of existing commercial services in China. CONCLUSIONS This comparison between two groups of cases illustrates that, with the proposed method, the accuracy of mandibular defect repair surgery is increased significantly and is less time-consuming, and patients are satisfied with both the recovery of oral function and their appearance. Until now, more than 15 cases have been treated with the proposed methods, so their feasibility and validity have been verified.
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Affiliation(s)
- Yun-feng Liu
- Key Laboratory of E&M (Zhejiang University of Technology), Ministry of Education & Zhejiang Province, Hangzhou 310014, China.
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Biomechanical analysis of a curvilinear distractor device for correcting mandibular symphyseal defects. J Oral Maxillofac Surg 2014; 72:1158-67. [PMID: 24388177 DOI: 10.1016/j.joms.2013.10.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2013] [Revised: 10/19/2013] [Accepted: 10/23/2013] [Indexed: 11/21/2022]
Abstract
PURPOSE The local mechanical environment is a determinant of successful transport disc distraction osteogenesis. This study assessed the biomechanics of a curvilinear distractor device for correcting mandibular symphyseal defects. MATERIALS AND METHODS The finite element method was used to analyze an intact mandible, mandibular distractor bodies with different rail thicknesses (4, 6, 8, and 10 mm), and mandibular distractor bodies with rails and auxiliary lingual brackets. RESULTS Rail thickness was positively correlated with maximum von Mises stress in the distractor and negatively correlated with maximum displacement of the mandibular distractor bodies. The maximum von Mises stress occurred at the junction of the rails and fixed arms. It also exceeded the yield strength of the titanium material. Compared with the maximum displacement of the intact mandible, that of the mandibular distractor bodies was visibly increased. CONCLUSION An auxiliary lingual bracket can effectively decrease stress in such devices and displacement of mandibular distractor bodies. Rail fixation alone cannot achieve stability for distraction osteogenesis. Using an auxiliary lingual bracket effectively prevents distractor breakage and exposure.
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Ghassemi A, Jost M, Fitzner C, Jalaie H, Hölzle F, Apitzsch J, Modabber A, Nanhekhan L. Factors influencing the necessity for preoperative vascular imaging before harvesting a vascularized fibular flap. Oral Surg Oral Med Oral Pathol Oral Radiol 2013; 117:289-92. [PMID: 24393632 DOI: 10.1016/j.oooo.2013.11.492] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2013] [Revised: 10/13/2013] [Accepted: 11/04/2013] [Indexed: 12/01/2022]
Abstract
OBJECTIVE This study was carried out to identify groups of patients who would benefit from this angiography. The angiographic images of a random group of patients were studied; the correlations between the vascular state of the lower extremities and vessel pathology were investigated; and the possible links of these findings with certain medical conditions were explored. STUDY DESIGN Three experienced observers independently evaluated the angiograms of 185 patients. The status of all 3 vessels of the lower extremities (anterior tibial artery, posterior tibial artery, and peroneal artery) was evaluated. The patients' gender, age, drinking and smoking habits, and medical conditions were documented. RESULTS We found a significant correlation between pathology of the arteries of the lower extremity and blood cholesterol level, blood pressure, coronary heart disease, diabetes mellitus, and age. CONCLUSIONS We suggest that preoperative vascular imaging be carried out in patients with comorbidities to reduce the potential for flap failure and to minimize donor site complications.
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Affiliation(s)
- Alireza Ghassemi
- Department of Oral, Maxillofacial and Plastic Facial Surgery, University Hospital of Rheinisch-Westfälische Technische Hochschule Aachen, Aachen, Germany.
| | - Maike Jost
- Private Dental Practice, Oberhausen, Germany
| | - Christina Fitzner
- Institute of Medical Statistics, University of Rheinisch-Westfälische Technische Hochschule Aachen, Aachen, Germany
| | - Houman Jalaie
- Department of Vascular Surgery, University Hospital of Rheinisch-Westfälische Technische Hochschule Aachen, Aachen, Germany
| | - Frank Hölzle
- Department of Oral, Maxillofacial and Plastic Facial Surgery, University Hospital of Rheinisch-Westfälische Technische Hochschule Aachen, Aachen, Germany
| | - Jonas Apitzsch
- Department of Diagnostic and Interventional Radiology, University Hospital of Rheinisch-Westfälische Technische Hochschule Aachen, Aachen, Germany
| | - Ali Modabber
- Department of Oral, Maxillofacial and Plastic Facial Surgery, University Hospital of Rheinisch-Westfälische Technische Hochschule Aachen, Aachen, Germany
| | - Lloyd Nanhekhan
- Department of Plastic, Reconstructive and Aesthetic Surgery, University Hospitals Leuven, Leuven, Belgium
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Uçan MC, Koparal M, Ağaçayak S, Gunay A, Ozgoz M, Atilgan S, Yaman F. Influence of caffeic acid phenethyl ester on bone healing in a rat model. J Int Med Res 2013; 41:1648-54. [PMID: 24065455 DOI: 10.1177/0300060513490613] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVE To examine the effects of caffeic acid phenethyl ester (CAPE; a component of honey bee-hive propolis with antioxidant, anti-inflammatory, antiviral and anticancer properties) on bone regeneration and fibrotic healing in a rat model. METHODS Male Sprague-Dawley rats (n = 63; mean age 7 weeks; weight 280-490 g) were randomly divided into three groups: A, cranial defect with no bone healing treatment (n = 21); B, cranial defect treated with CAPE (n = 21); C, cranial defect treated with CAPE and β-tricalcium phosphate/hydroxyl apatite (n = 21). Rats were anaesthetized with ketamine (8 mg/100 g) by intraperitoneal injection and a cranial critical size bone defect was created. Following surgery, CAPE (10 µmol/kg) was administered by daily intraperitoneal injection. Seven rats in each group were killed at days 7, 15 and 30 following surgery. Bone regeneration, fibrotic healing and osteoblast activity were evaluated by histopathology. RESULTS Statistically significant differences in healing were found between all groups. There were no statistically significant within-group differences between day 7 and 15. At day 30, bone healing scores were significantly higher in groups B and C compared with group A. CONCLUSION CAPE significantly improved bone-defect healing in a rat model, suggesting that CAPE has beneficial effects on bone healing.
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Affiliation(s)
- M C Uçan
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Dicle University, Turkey
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Virtual Surgical Planning in Complex Composite Maxillofacial Reconstruction. Plast Reconstr Surg 2013; 132:626-633. [DOI: 10.1097/prs.0b013e31829ad299] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Coyle M, Godden A, Brennan PA, Cascarini L, Coombes D, Kerawala C, McCaul J, Godden D. Dynamic reanimation for facial palsy: an overview. Br J Oral Maxillofac Surg 2013; 51:679-83. [PMID: 23385066 DOI: 10.1016/j.bjoms.2012.12.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2012] [Accepted: 12/19/2012] [Indexed: 10/27/2022]
Abstract
Facial paralysis can have a profound effect on the patient from both an aesthetic and functional point of view. The symptoms depend on which branch of the nerve has been damaged and the severity of the injury. The purpose of this paper is to review currently available treatments for dynamic reanimation of a damaged facial nerve, and the goals are a symmetrical and coordinated smile. Careful selection of patients and use of the appropriate surgical technique can have excellent results.
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Affiliation(s)
- Margaret Coyle
- Department of Oral and Maxillofacial Surgery, North Bristol NHS Trust, Frenchay Hospital, Bristol BS16 1LE, United Kingdom.
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