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Hagmann A, Schappacher R, Pietzka S, Sakkas A, Scheurer M, Schramm A, Wilde F, Ebeling M. Comparison of Laser-Sintered and Milled Patient-Specific Reconstruction Plates for Complications and Outcomes in Mandibular Defects-Comparative Analysis of a Single-Center Cohort. J Pers Med 2023; 13:jpm13040648. [PMID: 37109034 PMCID: PMC10142247 DOI: 10.3390/jpm13040648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Revised: 04/06/2023] [Accepted: 04/08/2023] [Indexed: 04/29/2023] Open
Abstract
CAD/CAM-manufactured implants are increasingly becoming the standard in current therapy. The question of whether the manufacturing-related rougher surface of selective laser fusion plates compared to milled, smoother reconstruction plates leads to increased postoperative complications such as infections, plate exposure, and fistulas has not yet been determined. A retrospective analysis of 98 patients who underwent surgical treatment with either a selective laser fusion plate or a milled reconstruction plate at our hospital was performed. The only significant predictors of the revision risk were the operation time and use of antiresorptive medication. In the KLS Martin® group, the risk of revision decreased by approximately 20% for each additional hour by which the operation time was increased (OR = 0.81). In the Depuy Synthes® group, the risk of revision increased by approximately 11% with each additional hour of operative time (OR = 0.81 × 1.37 = 1.11). Both groups showed no significant differences in the number of necessary revision surgeries as well as inpatient complications. In summary, we can say that the assumption that additively manufactured reconstruction plates have a rougher surface due to selective laser melting and thus make plaque accumulation and revisions more likely has not been confirmed. Overall, it seems imperative to select further studies regarding the clinical outcome depending on the selected plate system.
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Affiliation(s)
- Alexander Hagmann
- Medical School, University Hospital Ulm, Albert-Einstein-Allee 23, 89081 Ulm, Germany
| | - Robert Schappacher
- Department of Oral and Plastic Maxillofacial Surgery, Marienhospital, Böheimstraße 37, 70199 Stuttgart, Germany
| | - Sebastian Pietzka
- Department of Oral and Plastic Maxillofacial Surgery, Military Hospital Ulm, Academic Hospital of the University of Ulm, Oberer Eselsberg 40, 89081 Ulm, Germany
- Department of Oral and Maxillofacial Surgery, University Hospital Ulm, Albert-Einstein-Allee 10, 89081 Ulm, Germany
| | - Andreas Sakkas
- Department of Oral and Plastic Maxillofacial Surgery, Military Hospital Ulm, Academic Hospital of the University of Ulm, Oberer Eselsberg 40, 89081 Ulm, Germany
- Department of Oral and Maxillofacial Surgery, University Hospital Ulm, Albert-Einstein-Allee 10, 89081 Ulm, Germany
| | - Mario Scheurer
- Department of Oral and Plastic Maxillofacial Surgery, Military Hospital Ulm, Academic Hospital of the University of Ulm, Oberer Eselsberg 40, 89081 Ulm, Germany
| | - Alexander Schramm
- Department of Oral and Plastic Maxillofacial Surgery, Military Hospital Ulm, Academic Hospital of the University of Ulm, Oberer Eselsberg 40, 89081 Ulm, Germany
- Department of Oral and Maxillofacial Surgery, University Hospital Ulm, Albert-Einstein-Allee 10, 89081 Ulm, Germany
| | - Frank Wilde
- Department of Oral and Plastic Maxillofacial Surgery, Military Hospital Ulm, Academic Hospital of the University of Ulm, Oberer Eselsberg 40, 89081 Ulm, Germany
- Department of Oral and Maxillofacial Surgery, University Hospital Ulm, Albert-Einstein-Allee 10, 89081 Ulm, Germany
| | - Marcel Ebeling
- Department of Oral and Plastic Maxillofacial Surgery, Military Hospital Ulm, Academic Hospital of the University of Ulm, Oberer Eselsberg 40, 89081 Ulm, Germany
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