Jung HY, Cho JY, Jung S, Park HJ, Oh HK, Ryu J. Can Fracture Reduction be Attempted Through a 3D-Printed Guide Template Without Maxillomandibular Fixation?
J Oral Maxillofac Surg 2023:S0278-2391(23)00399-3. [PMID:
37220868 DOI:
10.1016/j.joms.2023.05.002]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 04/20/2023] [Accepted: 05/01/2023] [Indexed: 05/25/2023]
Abstract
BACKGROUND
Computer-aided design and manufacturing is widely used in clinical practice. This technology may change existing methods for mandibular fracture management.
PURPOSE
The purpose of this in-vitro study was to determine if the reduction for mandibular symphysis fracture is performed without maxillomandibular fixation (MMF) using 3-dimensional (3D)-printed template.
STUDY DESIGN, SETTING, AND SAMPLE
This was an in-vitro study and had the character of a proof-of-concept study. The study was planned using the existing 20 pairs of intraoral scan and computed tomography data. The mandibular model STL file was created by merging the STL file obtained for the bimaxillary dentitions with the computed tomography DICOM file, and this was set as the original model. In the original model, STL file of fracture model of mandibular symphysis was created using computer-aided design. A template similar to a wafer or an implant guide was manufactured from restoring the own occlusion, and the mandibular fracture model was reduced and fixed using the 3D-printed template and wire, and this was set as the experimental group. The 3D coordinate system error was measured at 6 landmarks and statistically compared using scan data between models of the groups.
PREDICTOR/EXPOSURE/INDEPENDENT VARIABLES
Reduction techniques with MMF or without MMF using guide template for mandibular fracture model.
MAIN OUTCOME VARIABLE(S)
The 3D coordinate system error (mm).
COVARIATES
The position of landmarks.
ANALYSES
The Mann-Whitney U test, student's t-test, and the Kruskal-Wallis test were used to analyze the coordinate errors between the landmarks. A P value of < .05 was considered statistically significant.
RESULTS
The 3D error value of the control and experimental group were 1.06 ± 0.63 mm (range: 0.11 to 2.92 mm) and 0.96 ± 0.48 mm (range: 0.2 to 2.95 mm), respectively. There was no statistical difference between the control and experimental group. There was a statistically significant difference in the lower 2 and lower 3 landmarks compared to the upper 1 (P = .001 and .000, respectively) before and after the reduction in the experimental group.
CONCLUSION AND RELEVANCE
This study demonstrates that the reduction using a 3D-printed guide template for the mandibular symphysis fracture could be possible even without the MMF.
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