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Srivastava G, Padhiary SK, Mohanty N, Patil PG, Panda S, Cobo-Vazquez C, Çakmak G, Molinero-Mourelle P. Digital workflow feasibility for the fabrication of intraoral maxillofacial prosthetics after surgical resection: a systematic literature review. Acta Odontol Scand 2024; 83:392-403. [PMID: 38895776 PMCID: PMC11302490 DOI: 10.2340/aos.v83.40870] [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: 04/10/2024] [Accepted: 05/24/2024] [Indexed: 06/21/2024]
Abstract
OBJECTIVES To evaluate the current evidence of digital workflow feasibility based on the data acquisition methods and the software tools used to fabricate intraoral prostheses for patients with partial or total maxillary and mandibular defects. MATERIALS AND METHODS An electronic search was performed in PubMed, SCOPUS, and Web of Science using a combination of relevant keywords: digital workflow, digital designing, computer-assisted design-computer aided manufacturing, 3D printing, maxillectomy, and mandibulectomy. The Joanna Briggs Institute Critical Appraisal Tool was used to assess the quality of evidence in the studies reviewed. RESULTS From a total of 542 references, 33 articles were selected, including 25 on maxillary prostheses and 8 on mandibular prostheses. The use of digital workflows was limited to one or two steps of the fabrication of the prostheses, and only four studies described a complete digital workflow. The most preferred method for data acquisition was intraoral scanning with or without a cone beam computed tomography combination. CONCLUSION Currently, the fabrication process of maxillofacial prostheses requires combining digital and conventional methods. Simplifying the data acquisition methods and providing user-friendly and affordable software may encourage clinicians to use the digital workflow more frequently for patients requiring maxillofacial prostheses.
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Affiliation(s)
- Gunjan Srivastava
- Department of Prosthodontics, Institute of Dental Sciences, Siksha 'O' Anusandhan Deemed to be University, Bhubaneswar, India.
| | - Subrat Kumar Padhiary
- Department of Oral and Maxillofacial Surgery, Institute of Dental Sciences, Siksha 'O' Anusandhan Deemed to be Univesity, Bhubaneswar, India
| | - Neeta Mohanty
- Department of Oral and Maxillofacial Pathology, Institute of Dental Sciences, Siksha 'O' Anusandhan Deemed to be University, Bhubaneswar, India
| | - Pravinkumar G Patil
- Department of Prosthodontics, Division of Restorative Dentistry, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia
| | - Saurav Panda
- Department of Periodontics, Institute of Dental Sciences, Siksha 'O' Anusandhan, University, Bhubaneswar, India
| | - Carlos Cobo-Vazquez
- Department of Dental Clinical Specialties, Faculty of Dentistry, Complutense University of Madrid, Madrid, Spain
| | - Gülce Çakmak
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Pedro Molinero-Mourelle
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
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Hu Y, Liu J, Wu W, Wang Z. Immediate reconstruction of defects after a partial maxillectomy with a digitally planned, prefabricated, 3-dimensionally printed, esthetic obturator prosthesis. J Prosthet Dent 2023:S0022-3913(23)00064-1. [PMID: 36841709 DOI: 10.1016/j.prosdent.2023.01.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 01/05/2023] [Accepted: 01/06/2023] [Indexed: 02/26/2023]
Abstract
A digital workflow was used to design and prefabricate a 3-dimensionally printed, esthetic obturator prosthesis for immediate placement after a partial maxillectomy. The approach involved simultaneous reciprocation and support of the maxillary defect during the surgery and minimized the incidence of cicatricial contracture of the soft tissue, preventing permanent facial deformity and dysfunction.
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Affiliation(s)
- Yongjie Hu
- Professor, Department of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiaotong University School of Medicine; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, PR China
| | - Jiannan Liu
- Associate Professor, Department of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiaotong University School of Medicine; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, PR China
| | - Wenyan Wu
- Resident, Department of Stomatology, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Zhen Wang
- Assistant Professor, Department of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiaotong University School of Medicine; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, PR China.
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Obturator Manufacturing for Oronasal Fistula after Cleft Palate Repair: A Review from Handicraft to the Application of Digital Techniques. J Funct Biomater 2022; 13:jfb13040251. [PMID: 36412892 PMCID: PMC9680338 DOI: 10.3390/jfb13040251] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 11/09/2022] [Accepted: 11/15/2022] [Indexed: 11/19/2022] Open
Abstract
An oronasal fistula (ONF) is an abnormal structure between the oral and nasal cavities, which is a common complication of cleft palate repair due to the failure of wound healing. When some patients with ONF are unsuitable for secondary surgical repair, the obturator treatment becomes a potential method. The objectives of the obturator treatment should be summarized as filling the ONF comfortably and cosmetically restoring the dentition with partial function. The anatomy of patients with cleft palate is complex, which may lead to a more complex structure of the ONF. Thus, the manufacturing process of the obturator for these patients is more difficult. For performing the design and fabrication process rapidly and precisely, digital techniques can help, but limitations still exist. In this review, literature searches were conducted through Medline via PubMed, Wiley Online Library, Science Direct, and Web of Science, and 122 articles were selected. The purpose of this review was to introduce the development of the obturator for treating patients with ONF after cleft palate repair, from the initial achievement of the obstruction of the ONF to later problems such as fixation, velopharyngeal insufficiency, and infection, as well as the application of digital technologies in obturator manufacturing.
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The use of 3D virtual surgical planning and computer aided design in reconstruction of maxillary surgical defects. Curr Opin Otolaryngol Head Neck Surg 2020; 28:122-128. [PMID: 32102008 DOI: 10.1097/moo.0000000000000618] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW The present review describes the latest development of 3D virtual surgical planning (VSP) and computer aided design (CAD) for reconstruction of maxillary defects with an aim of fully prosthetic rehabilitation. The purpose is to give an overview of different methods that use CAD in maxillary reconstruction in patients with head and neck cancer. RECENT FINDINGS 3D VSP enables preoperative planning of resection margins and osteotomies. The current 3D VSP workflow is expanded with multimodal imaging, merging decision supportive information. Development of more personalized implants is possible using CAD, individualized virtual muscle modelling and topology optimization. Meanwhile the translation of the 3D VSP towards surgery is improved by techniques like intraoperative imaging and augmented reality. Recent improvements of preoperative 3D VSP enables surgical reconstruction and/or prosthetic rehabilitation of the surgical defect in one combined procedure. SUMMARY With the use of 3D VSP and CAD, ablation surgery, reconstructive surgery, and prosthetic rehabilitation can be planned preoperatively. Many reconstruction possibilities exist and a choice depends on patient characteristics, tumour location and experience of the surgeon. The overall objective in patients with maxillary defects is to follow a prosthetic-driven reconstruction with the aim to restore facial form, oral function, and do so in accordance with the individual needs of the patient.
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Vosselman N, Alberga J, Witjes MHJ, Raghoebar GM, Reintsema H, Vissink A, Korfage A. Prosthodontic rehabilitation of head and neck cancer patients-Challenges and new developments. Oral Dis 2020; 27:64-72. [PMID: 32343862 PMCID: PMC7818410 DOI: 10.1111/odi.13374] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 03/27/2020] [Accepted: 04/20/2020] [Indexed: 01/23/2023]
Abstract
Head and neck cancer treatment can severely alter oral function and aesthetics, and reduce quality of life. The role of maxillofacial prosthodontists in multidisciplinary treatment of head and neck cancer patients is essential when it comes to oral rehabilitation and its planning. This role should preferably start on the day of first intake. Maxillofacial prosthodontists should be involved in the care pathway to shape and outline the prosthetic and dental rehabilitation in line with the reconstructive surgical options. With the progress of three‐dimensional technology, the pretreatment insight in overall prognosis and possibilities of surgical and/or prosthetic rehabilitation has tremendously increased. This increased insight has helped to improve quality of cancer care. This expert review addresses the involvement of maxillofacial prosthodontists in treatment planning, highlighting prosthodontic rehabilitation of head and neck cancer patients from start to finish.
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Affiliation(s)
- Nathalie Vosselman
- Department of Oral and Maxillofacial Surgery, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands
| | - Jamie Alberga
- Department of Oral and Maxillofacial Surgery, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands
| | - Max H J Witjes
- Department of Oral and Maxillofacial Surgery, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands
| | - Gerry M Raghoebar
- Department of Oral and Maxillofacial Surgery, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands
| | - Harry Reintsema
- Department of Oral and Maxillofacial Surgery, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands
| | - Arjan Vissink
- Department of Oral and Maxillofacial Surgery, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands
| | - Anke Korfage
- Department of Oral and Maxillofacial Surgery, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands
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Palin CL, Huryn JM, Golden M, Booth PR, Randazzo JD. Three-dimensional printed definitive cast for a silicone obturator prosthesis: A clinical report. J Prosthet Dent 2019; 121:353-357. [PMID: 30392749 PMCID: PMC6785976 DOI: 10.1016/j.prosdent.2018.04.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Revised: 04/15/2018] [Accepted: 04/16/2018] [Indexed: 11/29/2022]
Abstract
For patients with head and neck cancer requiring a maxillectomy, obturator prostheses help with quality of life. These patients routinely require adjuvant oncologic treatments with significant adverse effects. Treatment sequelae can leave patients with difficulty speaking and swallowing, reduced salivary function, reduction in maximal incisal opening, and at risk of osteoradionecrosis. A 55-year-old African-American woman presented with significant trismus and reduction in maximal incisal opening after treatment for squamous cell carcinoma of the left maxillary sinus. She had received a left total maxillectomy with adjuvant chemotherapy and radiation treatments. With her reduced opening, she was no longer able to insert her interim obturator prosthesis, which caused difficulty speaking and nasal regurgitation. A cone beam computed tomography scan was made of the patient's maxillectomy defect. From the Digital Imaging and Communications in Medicine file, a definitive cast was 3-dimensionally printed to fabricate a flexible silicone obturator prosthesis. This treatment has allowed the patient to return to a functional quality of life and could help other patients in similar situations.
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Affiliation(s)
- Charles L Palin
- Maxillofacial Prosthetics Fellow, Dental Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Joseph M Huryn
- Chief, Dental Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Marjorie Golden
- Maxillofacial Prosthetics Technician, Dental Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Paul R Booth
- Supervisor, Biomedical Systems Section, Biomedical Engineering, Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Joseph D Randazzo
- Maxillofacial Prosthetics Director, Dental Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY.
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Anderson J, Wealleans J, Ray J. Endodontic applications of 3D printing. Int Endod J 2018; 51:1005-1018. [DOI: 10.1111/iej.12917] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 02/22/2018] [Indexed: 12/23/2022]
Affiliation(s)
- J. Anderson
- Endodontics; US Air Force Postgraduate Dental School; Uniformed Services University; JBSA-Lackland TX USA
| | - J. Wealleans
- Endodontics; US Air Force Postgraduate Dental School; Uniformed Services University; JBSA-Lackland TX USA
| | - J. Ray
- Endodontics; US Air Force Postgraduate Dental School; Uniformed Services University; JBSA-Lackland TX USA
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