Individually Prefabricated Prosthesis for Maxilla Reconstruction.

Abstract

The reconstruction of maxillofacial bone defects by the intraoperative modeling of implants may reduce the predictability of the esthetic result, leading to more invasive surgery and increased surgical time. To improve the maxillofacial surgery outcome, modern manufacturing methods such as rapid prototyping (RP) technology and methods based on reverse engineering (RE) and medical imaging data are applicable to the manufacture of custom-made maxillary prostheses. After acquisition of data, an individual computer-based 3D model of the bony defect is generated. These data are transferred into RE software to create the prosthesis using a computer-aided design (CAD) model, which is directed into the RP machine for the production of the physical model. The precise fit of the prosthesis is evaluated using the prosthesis and skull models. The prosthesis is then directly used in investment casting such as "Quick Cast" pattern to produce the titanium model. In the clinical reports presented here, reconstructions of two patients with large maxillary bone defects were performed using this new method. The custom prostheses perfectly fit the defects during the operations, and surgery time was reduced. These cases show that the prefabrication of a prosthesis using modern manufacturing technology is an effective method for maxillofacial defect reconstruction.