Abstract
ObjectiveTo investigate the adherence to initially planned maxillofacial reconstructions using computer-assisted surgery (CAS) and to identify the influential factors affecting its compliance for maxillofacial reconstruction.Patients and MethodsA retrospective analysis of 136 computer-assisted maxillofacial reconstructive surgeries was conducted from January 2014 to June 2020. The categorical parameters involved age, gender, disease etiology, disease site, defect size, bone flap segments, and flap type. Apart from descriptive data reporting, categorical data were related by applying the Fisher-exact test, and a p-value below 5% was considered statistically significant (P < 0.05).ResultsThe main reasons for partial or non-adherence included unfitness, patient health condition, and other subjective reasons. Out of the total patient population, 118 patients who underwent mandibular reconstruction showed higher CAS compliance (83.9%) compared to the 18 midface reconstruction (72.2%) without any statistically significant difference (p = 0.361). Based on the size of the defect, a significantly higher CAS compliance (p = 0.031) was observed with a minor defect (80.6%) compared to the large-sized ones (74.1%). The bone flaps with two or more segments were significantly (p = 0.003) prone to observe a partial (15.4%) or complete (12.8%) discard of the planned CAS compared to the bone flaps with less than two segments. The malignant tumors showed the lowest CAS compliance when compared to other disorders without any significant difference (p = 0.1).ConclusionThe maxillofacial reconstructive surgical procedures offered optimal compliance to the initially planned CAS. However, large-sized defects and multiple bone flap segments demonstrated a higher risk of partial or complete abandonment of the CAS.
Highlights
Reconstructive maxillofacial surgery following tumor resection, trauma, osteonecrosis, and other infectious diseases is vital for restoring facial aesthetics, function, oral rehabilitation and improving the patient’s quality of life (QOL) [1]
A total of 210 patients who underwent computer-assisted surgery (CAS)-based maxillofacial reconstruction were screened from January 2014 to June 2020
The present study explored the conformity to CAS for maxillofacial reconstructive procedures and investigated the influence of the parameters to identify the reasons it was partially executed or wholly discarded
Summary
Reconstructive maxillofacial surgery following tumor resection, trauma, osteonecrosis, and other infectious diseases is vital for restoring facial aesthetics, function, oral rehabilitation and improving the patient’s quality of life (QOL) [1]. The maxillofacial region mandates special care from a surgeon as it occupies a central position concerning the aesthetics and functionality, as an inadequate reconstruction might negatively influence the final outcome [2]. With the advent of computer-assisted surgery (CAS) and threedimensional (3D) printing, the reconstructive surgical accuracy and patient- and surgery-related outcomes have significantly improved [3, 4]. CAS has played a vital role in improving the oral rehabilitation by increasing the predictability of replacing missing teeth with both firstand second-stage dental implant placement in the grafted region [5].
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