Minimal invasive treatment using patient-specific template for mandibular fractures in children: “Wing-splint” by CAD/CAM technology

Abstract

w b m s R t to seat the splint accurately, which should be at least 3 mm thick, so that it is rigid enough to fix the mandible (Fig. 2). ircummandibular fixation with wire and acrylic splints is ommonly used for the treatment of mandibular fractures n children, but has some shortcomings, including addiional laboratory processing, which can increase the duration f the general anaesthesia or require additional sedation.1,2 iodegradable fixation can be also used but also mean proonged operating time and technical difficulties, and the oreign body used can cause a reaction.3 We present a simple, inimally-invasive technique based on the concept of exteral fixation that uses a template that is specific to the patient.4 We take a high-resolution computed tomogram (CT) of he craniofacial skeleton according to a standard protocol. atasets from this or any initial diagnostic scans that we lready have are imported into software (Mimics, Materilise, Leuven, Belgium) and converted to a 3-dimensional irtual model. The teeth are then separated from the virtual andible so that we can see the roots of mixed dentition and ermanent tooth buds. Before the virtual reduction, we create our cylinders (2.0 mm in diameter) on the mandible (Fig. 1). his is to allow us to position fixation screws precisely and