Submit to JPM Review for JPM Propose a Special Issue

Journal Menu

Journal Browser

Computer Assisted Maxillo-Facial Surgery

Special Issue Editors
Special Issue Information
Keywords
Benefits of Publishing in a Special Issue
Published Papers

A special issue of Journal of Personalized Medicine (ISSN 2075-4426). This special issue belongs to the section "Methodology, Drug and Device Discovery".

Deadline for manuscript submissions: closed (30 April 2023) | Viewed by 30877

Share This Special Issue

Special Issue Editors

Dr. Giovanni Gerbino

E-Mail Website
Guest Editor

Department of Surgical Sciences, Division of Maxillofacial Surgery, University of Turin, 10129 Turin, Italy
Interests: computer assisted maxillofacial surgery; orthognatic surgery; orbital surgery; tmj surgery; maxillofacial trauma

Dr. Emanuele Zavattero

E-Mail Website
Guest Editor

Department of Surgical Sciences, Division of Maxillofacial Surgery, University of Turin, 10129 Turin, Italy
Interests: computer assisted maxillofacial surgery; microsurgery; maxillofacial trauma; oncology

Special Issue Information

Dear Colleagues,

In the last 25 years, the rapid advances in 3D imaging, computer aided design and computer aided manufacturing (CAD/CAM), rapid prototyping technologies, and intraoperative navigation have led to the development of computer assisted surgery (CAS), in which pre-, intra-, and postoperative phases are inextricably linked together in a dynamic chain which improves the predictability, feasibility, and clinical outcome of complex surgical operations.

The transfer of 3D imaging, and computer aided design and manufacturing with powerful software, from industry to medicine has allowed the enormous improvement of structural diagnostic processes, and consequently of planning and 3D virtual simulation of surgical procedures. The application of computer aided manufacturing and 3D printing in medical fields such as traumatology, orthopedics, neurosurgery, implant dentistry, reconstructive plastic surgery, and craniomaxillofacial surgery has led to the production of different patient specific surgical tools as anatomical models, cutting and positioning guides, patient specific implant, and fixation devices. Theis has allowed better results, and more predictable and less invasive surgeries, as witnessed by a steadily increasing number of studies.

These processes have quickly progressed to different surgical specialties, moving from hard tissue to soft tissue, adapting technologies to different and new challenges.

The spread of 3D printing and free source medical software has made in-house, low-cost application of these technologies possible, increasing the flexibility and availability of treatments. Craniomaxillofacial surgery has been a cornerstone in the development of high precision surgery, based on the integration of digital technologies, rapid prototyping, and less invasive surgery. Today, oral and craniomaxillofacial surgery are at the cutting edge of personalized, patient specific, customized medicine.

In this Special Issue of JPM, leading researchers and surgeons will present an overview of the role of computer assisted surgery in the development of personalized, patient centered medicine. Future research will open up the chance for further clinical applications of digital technology in surgery.

Dr. Giovanni Gerbino
Dr. Emanuele Zavattero
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Personalized Medicine is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

computer assisted surgery
orthognatic surgery
reconstructive surgery
3D printing
patient specific implants
virtual planning

Benefits of Publishing in a Special Issue

Ease of navigation: Grouping papers by topic helps scholars navigate broad scope journals more efficiently.
Greater discoverability: Special Issues support the reach and impact of scientific research. Articles in Special Issues are more discoverable and cited more frequently.
Expansion of research network: Special Issues facilitate connections among authors, fostering scientific collaborations.
External promotion: Articles in Special Issues are often promoted through the journal's social media, increasing their visibility.
e-Book format: Special Issues with more than 10 articles can be published as dedicated e-books, ensuring wide and rapid dissemination.

Further information on MDPI's Special Issue polices can be found here.

Published Papers (14 papers)

Download All Papers

Order results

Result details

Show export options Show export options

Select all

Export citation of selected articles as:

Research

Jump to: Other

13 pages, 8976 KiB

Open AccessArticle

Unilateral Cleft Lip and Palate Has Asymmetry of Bony Orbits: A Retrospective Study

by Eeva Kormi, Elina Peltola, Niilo Lusila, Arja Heliövaara, Junnu Leikola and Juho Suojanen

J. Pers. Med. 2023, 13(7), 1067; https://doi.org/10.3390/jpm13071067 - 29 Jun 2023

Cited by 1 | Viewed by 2053

Abstract

Facial asymmetry is common in unilateral clefts. Since virtual surgical planning (VSP) is becoming more common and automated segmentation is utilized more often, the position and asymmetry of the orbits can affect the design outcome. The aim of this study is to evaluate whether non-syndromic unilateral cleft lip and palate (UCLP) patients requiring orthognathic surgery have asymmetry of the bony orbits. Retrospectively, we analyzed the preoperative cone-beam computed tomography (CBCT) or computed tomography (CT) data of UCLP (n = 15) patients scheduled for a Le Fort 1 (n = 10) or bimaxillary osteotomy (n = 5) with VSP at the Cleft Palate and Craniofacial Center, Helsinki University Hospital. The width, height, and depth of the bony orbit and the distance between the sella turcica and infraorbital canal were measured. A volumetric analysis of the orbits was also performed. The measurements were tested for distribution, and the cleft side and the contralateral side were compared statistically with a two-sided paired t-test. To assess asymmetry in the non-cleft population, we performed the same measurements of skeletal class III patients undergoing orthognathic surgery at Päijät-Häme Central Hospital (n = 16). The volume of bony orbit was statistically significantly smaller (p = 0.014), the distance from the infraorbital canal to sella turcica was shorter (p = 0.019), and the anatomical location of the orbit was more medio-posterior on the cleft side than on the contralateral side. The non-cleft group showed no statistically significant asymmetry in any measurements. According to these preliminary results, UCLP patients undergoing orthognathic surgery show asymmetry of the bony orbit not seen in skeletal class III patients without a cleft. This should be considered in VSP for the correction of maxillary hypoplasia and facial asymmetry in patients with UCLP. Full article

(This article belongs to the Special Issue Computer Assisted Maxillo-Facial Surgery)

► Show Figures

Figure 1

16 pages, 16892 KiB

Open AccessArticle

Accuracy Analysis of Computer-Assisted and Guided Dental Implantology by Comparing 3D Planning Data and Actual Implant Placement in a Mandibular Training Model: A Monocentric Comparison between Dental Students and Trained Implantologists

by Marcel Ebeling, Andreas Sakkas, Alexander Schramm, Frank Wilde, Mario Scheurer, Karsten Winter and Sebastian Pietzka

J. Pers. Med. 2023, 13(7), 1037; https://doi.org/10.3390/jpm13071037 - 24 Jun 2023

Viewed by 1255

Abstract

The aim of this study was to investigate how precisely implantation can be realized by participants on a phantom head according to preliminary planning. Of particular interest here was the influence of participants’ previous knowledge and surgical experience on the precision of the implant placement. The placed implants were scanned using an intraoral scanner, saved as STL files, and superimposed with the 3D-planned implant placement. Deviations from the planning were indicated in millimeters and degrees. We were able to show that on average, the deviations from computer-assisted 3D planning were less than 1 mm for implantologists, and the students also did not deviate more than 1.78 mm on average from 3D planning. This study shows that guided implantology provides predictable and reproducible results in dental implantology. Incorrect positioning, injuries to anatomical structures, and implant positions that cannot be prosthetically restored can thus be avoided. Full article

(This article belongs to the Special Issue Computer Assisted Maxillo-Facial Surgery)

► Show Figures

Figure 1

12 pages, 5214 KiB

Open AccessArticle

Comparison of Anatomical Preformed Titanium Implants and Patient-Specific CAD/CAM Implants in the Primary Reconstruction of Isolated Orbital Fractures—A Retrospective Study

by Sebastian Pietzka, Markus Wenzel, Karsten Winter, Frank Wilde, Alexander Schramm, Marcel Ebeling, Robin Kasper, Mario Scheurer and Andreas Sakkas

J. Pers. Med. 2023, 13(5), 846; https://doi.org/10.3390/jpm13050846 - 17 May 2023

Cited by 3 | Viewed by 2168

Abstract

Background/Aim: Reconstruction of the fractured orbit remains a challenge. The aim of this study was to compare anatomical preformed titanium orbital implants with patient-specific CAD/CAM implants for precision and intraoperative applicability. Material and Methods: A total of 75 orbital reconstructions from 2012 to 2022 were retrospectively assessed for their precision of implant position and intra- and postoperative revision rates. For this purpose, the implant position after digital orbital reconstruction was checked for deviations by mirroring the healthy orbit at 5 defined points, and the medical records of the patients were checked for revisions. Results: The evaluation of the 45 anatomical preformed orbital implant cases showed significantly higher deviations and an implant inaccuracy of 66.6% than the 30 CAD/CAM cases with only 10% inaccuracy. In particular, the CAD/CAM implants were significantly more precise in medial and posterior positioning. In addition, the intraoperative revision rates of 26.6% vs. 11% after 3D intraoperative imaging and the postoperative revision rates of 13% vs. 0 for the anatomical preformed implants were significantly higher than for patient-specific implants. Conclusion: We conclude that patient-specific CAD/CAM orbital implants are highly suitable for primary orbital reconstruction. These seem to be preferable to anatomical preformed implants in terms of precision and revision rates. Full article

(This article belongs to the Special Issue Computer Assisted Maxillo-Facial Surgery)

► Show Figures

Figure 1

16 pages, 2871 KiB

Open AccessArticle

Dental Root Injuries Caused by Osteosynthesis Screws in Orthognathic Surgery—Comparison of Conventional Osteosynthesis and Osteosynthesis by CAD/CAM Drill Guides and Patient-Specific Implants

by Sebastian Pietzka, Juliana Fink, Karsten Winter, Frank Wilde, Alexander Schramm, Marcel Ebeling, Robin Kasper and Andreas Sakkas

J. Pers. Med. 2023, 13(5), 706; https://doi.org/10.3390/jpm13050706 - 23 Apr 2023

Cited by 1 | Viewed by 2214

Abstract

Background/Aim: The primary aim was to evaluate the prevalence and localisation of dental injuries caused by osteosynthesis screws during orthognathic surgery, comparing two different CAD/CAM planning/surgical approaches through retrospective evaluation of post-operative computed tomography. Material and Methods: This study considered all patients who underwent orthognathic surgery from 2010–2019. The examination for dental root injuries between conventional osteosynthesis (Maxilla conventional cohort) and osteosynthesis with patient-specific implant (Maxilla PSI cohort) was performed by evaluating the post-operative CT scans. Results: A total of 126 patients were included in the study. Among the 61 patients of the Maxilla conventional cohort, 10 dental root injuries in 8 patients (13.1%) were detected in the post-operative CT scan, representing 1.5% (n = 10/651) of the osteosynthesis screws inserted in proximity of the alveolar crest. No dental injury occurred following osteosynthesis in the 65 patients of the Maxillary PSI cohort (n = 0/773 screws) (p < 0.001). During a mean follow-up period of 13 months after primary surgery, none of the injured teeth showed evidence of periapical alterations and no endodontic treatments were necessary. Conclusions: Maxillary positioning using CAD/CAM-fabricated drill/osteotomy guide and osteosynthesis with PSI can significantly reduce the risk for dental injury compared to the conventional procedure. However, the clinical significance of the detected dental injuries was rather minor. Full article

(This article belongs to the Special Issue Computer Assisted Maxillo-Facial Surgery)

► Show Figures

Figure 1

15 pages, 642 KiB

Open AccessArticle

Comparison of Laser-Sintered and Milled Patient-Specific Reconstruction Plates for Complications and Outcomes in Mandibular Defects—Comparative Analysis of a Single-Center Cohort

by Alexander Hagmann, Robert Schappacher, Sebastian Pietzka, Andreas Sakkas, Mario Scheurer, Alexander Schramm, Frank Wilde and Marcel Ebeling

J. Pers. Med. 2023, 13(4), 648; https://doi.org/10.3390/jpm13040648 - 9 Apr 2023

Viewed by 1110

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. Full article

(This article belongs to the Special Issue Computer Assisted Maxillo-Facial Surgery)

► Show Figures

Figure 1

11 pages, 11685 KiB

Open AccessArticle

Patient Specific Implants for Orbital Reconstruction in the Treatment of Silent Sinus Syndrome: Two Case Reports

by Elisa Raveggi, Federica Sobrero and Giovanni Gerbino

J. Pers. Med. 2023, 13(4), 578; https://doi.org/10.3390/jpm13040578 - 25 Mar 2023

Cited by 2 | Viewed by 3678

Abstract

Silent sinus syndrome is a rare disorder characterized by ipsilateral enophthalmos and hypoglobus following a collapse of the orbital floor, in the presence of asymptomatic long-term maxillary sinusitis. It results in enophthalmos, hypoglobus and deepening of the superior palpebral sulcus. A standardized treatment protocol for this infrequent syndrome has not yet been established. The management includes restoration of maxillary sinus ventilation with functional endoscopic sinus surgery and orbital reconstruction, either concurrently or separately. In this paper, the authors presented two patients successfully treated with patient-specific implants, and intraoperative navigation. These cases highlight the benefit of computer-assisted planning and titanium patient-specific implants in the management of silent sinus syndrome. To the best of our knowledge, this is the first report that described the use of PSI with titanium spacers performed with the aid of intraoperative navigation for SSS treatment. Advantages, drawbacks of this technique and treatment alternatives currently available in the literature were also discussed. Full article

(This article belongs to the Special Issue Computer Assisted Maxillo-Facial Surgery)

► Show Figures

Figure 1

9 pages, 3027 KiB

Open AccessArticle

Patient Satisfaction and Impact on Oral Health after Maxillary Rehabilitation Using a Personalized Additively Manufactured Subperiosteal Jaw Implant (AMSJI)

by Casper Van den Borre, Björn De Neef, Natalie A. J. Loomans, Marco Rinaldi, Erik Nout, Peter Bouvry, Ignace Naert and Maurice Y. Mommaerts

J. Pers. Med. 2023, 13(2), 297; https://doi.org/10.3390/jpm13020297 - 8 Feb 2023

Cited by 4 | Viewed by 2543

Abstract

Subperiosteal implants (SIs) were first developed by Dahl in 1941 for oral rehabilitation in case of severe jaw atrophy. Over time, this technique was abandoned due to the high success rate of endosseous implants. The emergence of patient-specific implants and modern dentistry allowed a revisitation of this 80-year-old concept resulting in a novel “high-tech” SI implant. This study evaluates the clinical outcomes in forty patients after maxillary rehabilitation with an additively manufactured subperiosteal jaw implant (AMSJI^®). The oral health impact profile-14 (OHIP-14) and numerical rating (NRS) scale were used to assess patient satisfaction and evaluate oral health. In total, fifteen men (mean age: 64.62 years, SD ± 6.75 years) and twenty-five women (mean age: 65.24 years, SD ± 6.77 years) were included, with a mean follow-up time of 917 days (SD ± 306.89 days) after AMSJI installation. Patients reported a mean OHIP-14 of 4.20 (SD ± 7.10) and a mean overall satisfaction based on the NRS of 52.25 (SD ± 4.00). Prosthetic rehabilitation was achieved in all patients. AMSJI is a valuable treatment option for patients with extreme jaw atrophy. Patients enjoy treatment benefits resulting in high patient satisfaction rates and impact on oral health. Full article

(This article belongs to the Special Issue Computer Assisted Maxillo-Facial Surgery)

► Show Figures

Figure 1

14 pages, 10930 KiB

Open AccessEditor’s ChoiceArticle

First-Hand Experience and Result with New Robot-Assisted Laser LeFort-I Osteotomy in Orthognathic Surgery: A Case Report

by Marcel Ebeling, Mario Scheurer, Andreas Sakkas, Frank Wilde and Alexander Schramm

J. Pers. Med. 2023, 13(2), 287; https://doi.org/10.3390/jpm13020287 - 3 Feb 2023

Cited by 5 | Viewed by 2984

Abstract

Background: We report the world’s first developer-independent experience with robot-assisted laser Le Fort I osteotomy (LLFO) and drill-hole marking in orthognathic surgery. To overcome the geometric limitations of conventional rotating and piezosurgical instruments for performing osteotomies, we used the stand-alone robot-assisted laser system developed by Advanced Osteotomy Tools. The aim here was to evaluate the precision of this novel procedure in comparison to the standard procedure used in our clinic using a computer-aided design/computer-aided manufacturing (CAD/CAM) cutting guide and patient-specific implant. Methods: A linear Le-Fort-I osteotomy was digitally planned and transferred to the robot. The linear portion of the Le-Fort I osteotomy was performed autonomously by the robot under direct visual control. Accuracy was analyzed by superimposing preoperative and postoperative computed tomography images, and verified intraoperatively using prefabricated patient-specific implant. Results: The robot performed the linear osteotomy without any technical or safety issues. There was a maximum difference of 1.5 mm on average between the planned and the performed osteotomy. In the robot-assisted intraoperative drillhole marking of the maxilla, which was performed for the first time worldwide, were no measurable deviations between planning and actual positioning. Conclusion: Robotic-assisted orthognathic surgery could be a useful adjunct to conventional drills, burrs, and piezosurgical instruments for performing osteotomies. However, the time required for the actual osteotomy as well as isolated minor design aspects of the Dynamic Reference Frame (DRF), among other things, still need to be improved. Still further studies for final evaluation of safety and accuracy are also needed. Full article

(This article belongs to the Special Issue Computer Assisted Maxillo-Facial Surgery)

► Show Figures

Figure 1

26 pages, 19228 KiB

Open AccessArticle

Computer-Aided Design and Computer-Aided Modeling (CAD/CAM) for Guiding Dental Implant Surgery: Personal Reflection Based on 10 Years of Real-Life Experience

by Paolo Scolozzi, Francesco Michelini, Claude Crottaz and Alexandre Perez

J. Pers. Med. 2023, 13(1), 129; https://doi.org/10.3390/jpm13010129 - 9 Jan 2023

Cited by 5 | Viewed by 2644

Abstract

Traditional dental implant surgery has been challenged by the phenomenal progression in computer-assisted surgery (CAS) that we have been witnessing in recent years. Among the computer-aided technologies, computer-aided design and computer-aided manufacturing (CAD/CAM) techniques represent by far the most attractive and accepted alternatives over their dynamic counterpart, navigational assistance. Based on many years of experience, we have determined that CAD/CAM technology for guiding dental implant surgery is valuable for rehabilitation of the anterior maxillary region and the management of complete or severe partial edentulism. The technology also guarantees the 3D parallelism of implants. The purpose of the present report is to describe indications for use of CAD/CAM dental implant guided surgery. We analyzed the clinical and radiological data of thirteen consecutive edentulous patients treated using CAD/CAM techniques. All of the patients had stable cosmetic results with a high rate of patient satisfaction at the final follow-up examination. No intra- and/or postoperative complications were encountered during any of the steps of the procedure. The application of CAD/CAM techniques produced successful outcomes in the patients presented in this series. Full article

(This article belongs to the Special Issue Computer Assisted Maxillo-Facial Surgery)

► Show Figures

Figure 1

14 pages, 3045 KiB

Open AccessEditor’s ChoiceArticle

A Ready-to-Use Grading Tool for Facial Palsy Examiners—Automated Grading System in Facial Palsy Patients Made Easy

by Leonard Knoedler, Maximilian Miragall, Martin Kauke-Navarro, Doha Obed, Maximilian Bauer, Patrick Tißler, Lukas Prantl, Hans-Guenther Machens, Peter Niclas Broer, Helena Baecher, Adriana C. Panayi, Samuel Knoedler and Andreas Kehrer

J. Pers. Med. 2022, 12(10), 1739; https://doi.org/10.3390/jpm12101739 - 19 Oct 2022

Cited by 19 | Viewed by 2791

Abstract

Background: The grading process in facial palsy (FP) patients is crucial for time- and cost-effective therapy decision-making. The House-Brackmann scale (HBS) represents the most commonly used classification system in FP diagnostics. This study investigated the benefits of linking machine learning (ML) techniques with the HBS. Methods: Image datasets of 51 patients seen at the Department of Plastic, Hand, and Reconstructive Surgery at the University Hospital Regensburg, Germany, between June 2020 and May 2021, were used to build the neural network. A total of nine facial poses per patient were used to automatically determine the HBS. Results: The algorithm had an accuracy of 98%. The algorithm processed the real patient image series (i.e., nine images per patient) in 112 ms. For optimized accuracy, we found 30 training runs to be the most effective training length. Conclusion: We have developed an easy-to-use, time- and cost-efficient algorithm that provides highly accurate automated grading of FP patient images. In combination with our application, the algorithm may facilitate the FP surgeon’s clinical workflow. Full article

(This article belongs to the Special Issue Computer Assisted Maxillo-Facial Surgery)

► Show Figures

Figure 1

14 pages, 3662 KiB

Open AccessArticle

Prospective Evaluation of Two Wall Orbital Fractures Involving the Medial Orbital Wall: PSI Reconstruction versus PDS Repair—Worth the Effort?

by Max Wilkat, Karsten Hufendiek, Merve Karahisarlioglu, Maria Borrelli, Christoph Sproll and Majeed Rana

J. Pers. Med. 2022, 12(9), 1389; https://doi.org/10.3390/jpm12091389 - 27 Aug 2022

Cited by 5 | Viewed by 2101

Abstract

Proper treatment of the two-wall fractured orbit is still controversial. Specifically, there is no consensus on the issue of the necessity of medial orbital wall repair. With anatomically critical structures at risk during the surgical approach, surgeons’ view on the necessity of medial orbital wall repair often is restricted and an aesthetically disturbing enophthalmos is more likely to be accepted. Therefore, treatment options range from leaving the medial wall without repair to reconstruction with autogenous tissue or alloplastic materials, which can lead to moderate to severe side effects. However, emerging technologies such as patient-specific implants (PSI) offer a reliable and anatomically correct reconstruction of the bony orbit. This study aimed to evaluate the outcome of full orbital reconstruction using PSIs compared to only orbital floor repair using PDS (bioresorbable polydioxanone) foils leaving the medial orbital wall untouched in traumatic two-wall orbital fractures. Of all patients treated at the University Hospital of Düsseldorf between 2017 and 2019 who suffered from traumatic orbital fracture, only patients with a two-wall orbital fracture involving both the orbital floor and the medial wall (n = 68) were included. Patients were treated either with a PSI (n = 35) or a PDS foil (n = 33). Primary outcome parameters were ophthalmological disturbances analyzed via clinical investigation and intra-orbital angles, volumes and implant position analyzed with radiological 3D-datasets. While a two-wall reconstruction using PSIs led to a significant improvement of the enophthalmos, the rate of postoperative enophthalmos was significantly increased in cases of only orbital floor repair with PDS foils. Radiologically, a significant reconstruction of the three-dimensional bony orbit succeeded with the simple use of PSIs leading to a significant reduction in the traumatically enlarged orbital volume. PSI also led to a significant reduction in the traumatically enlarged medial angle of the orbit. This was not the case for single-floor repair with PDS foil. The results of this study suggest that complex orbital fractures can be reconstructed at an even higher degree of accuracy with selective laser-melted PSIs than PDS foils. In order to achieve a true to original reconstruction of the bony orbit, surgical treatment of the medial orbital wall can be advocated for in the long term depending on the indication. Full article

(This article belongs to the Special Issue Computer Assisted Maxillo-Facial Surgery)

► Show Figures

Figure 1

Other

Jump to: Research

15 pages, 6108 KiB

Open AccessCase Report

Extended Complex Temporomandibular Joint Reconstructions Exploiting Virtual Surgical Planning, Navigation Assistance, and Custom-Made Prosthesis: A Comprehensive Protocol and Workflow

by Luca Raccampo, Salvatore Sembronio, Alessandro Tel and Massimo Robiony

J. Pers. Med. 2023, 13(6), 931; https://doi.org/10.3390/jpm13060931 - 31 May 2023

Cited by 5 | Viewed by 1412

Abstract

Background: Alloplastic temporomandibular joint (TMJ) replacement is a well-established procedure in maxillo-facial surgery. However, the surgical management of large excision in this area requires complex reconstruction beyond the standard TMJ prosthesis. Objective: This study aims to describe the design and the consequential application of a protocol which involves the use of computer-assisted surgery tools to best face complex TMJ reconstruction (TMJR). Preoperative accurate study of every single case and intraoperative check of the surgical act are nowadays essential to perform such delicate surgical procedures. Materials and Methods: The study is a retrospective and single institution case series. The various processes of the management and planning of extended TMJ reconstruction (eTMJR) are extensively described, from the preoperative clinical evaluation, imaging acquisition protocols and virtual surgical planning (VSP), focusing also on the intraoperative transfer of VSP using navigation and surgical guides. Results: We included nine patients with different pathologies which were candidates for eTMJR. Overall, the application of our protocol and workflow permitted the reduction of complications and pain, and the improvement of the maximum interincisal opening (MIO) of the patients, restoring patients’ masticatory function and esthetics. Conclusions: The eTMJR should be considered as a safe and reliable surgical management modality in selected patients with large temporomandibular joint and skull base (TMJ-SB) lesions. An accurate preoperative protocol and workflow is essential to perform such insidious and complex reconstruction. However, more extensive studies on this type of device have to be conducted in order to validate its real usefulness and indications. Full article

(This article belongs to the Special Issue Computer Assisted Maxillo-Facial Surgery)

► Show Figures

Figure 1

11 pages, 3609 KiB

Open AccessTechnical Note

Usage of Object Matching Algorithms Combined with Mixed Reality for Enhanced Decision Making in Orbital Reconstruction—A Technical Note

by Max Wilkat, Nadia Karnatz, Felix Schrader, Lara Schorn, Julian Lommen, Aida Parviz, Henriette Louise Möllmann and Majeed Rana

J. Pers. Med. 2023, 13(6), 922; https://doi.org/10.3390/jpm13060922 - 31 May 2023

Cited by 2 | Viewed by 1373

Abstract

This technical note describes the usage of object matching to virtually compare different modes of reconstruction in orbital trauma and display the results to the surgeon and the patient pre-operatively via mixed reality devices for enhanced surgical decision making and immersive patient education. A case of an orbital floor fracture is presented for which surface and volume matching were implemented to compare orbital reconstruction utilizing pre-fabricated titanium meshes versus patient-specific implants. The results could be visualized by mixed reality devices to further enhance surgical decision-making. The data sets were demonstrated to the patient in mixed reality for immersive patient education and enhanced shared decision making. The advantages of the new technologies are discussed in view of the new possibilities of improved patient education and informed consent processes, as well as new ways of teaching medical trainees. Full article

(This article belongs to the Special Issue Computer Assisted Maxillo-Facial Surgery)

► Show Figures

Figure 1

6 pages, 2233 KiB

Open AccessTechnical Note

Plasma Electrolytic Polished Patient-Specific Orbital Implants in Clinical Use—A Technical Note

by Lara Schorn, Max Wilkat, Julian Lommen, Maria Borelli, Sajjad Muhammad and Majeed Rana

J. Pers. Med. 2023, 13(1), 148; https://doi.org/10.3390/jpm13010148 - 11 Jan 2023

Cited by 5 | Viewed by 1552

Abstract

This technical note describes the technique of plasma electrolytic polishing on orbital patient-specific implants and demonstrates clinical handling and use by the insertion of a plasma electrolytic polished orbital implant into a patient. Full article

(This article belongs to the Special Issue Computer Assisted Maxillo-Facial Surgery)

► Show Figures

Journal Menu

Journal Browser

Computer Assisted Maxillo-Facial Surgery

Share This Special Issue

Special Issue Editors

Special Issue Information

Keywords

Benefits of Publishing in a Special Issue

Published Papers (14 papers)

Research

Other

Further Information

Guidelines

MDPI Initiatives

Follow MDPI