Abstract
BackgroundAlong with the advances in technology of three-dimensional (3D) printer, it became a possible to make more precise patient-specific 3D model in the various fields including oral and maxillofacial surgery. When creating 3D models of the mandible and maxilla, it is easier to make a single unit with a fused temporomandibular joint, though this results in poor operability of the model. However, while models created with a separate mandible and maxilla have operability, it can be difficult to fully restore the position of the condylar after simulation. The purpose of this study is to introduce and asses the novel condylar repositioning method in 3D model preoperational simulation.MethodsOur novel condylar repositioning method is simple to apply two irregularities in 3D models. Three oral surgeons measured and evaluated one linear distance and two angles in 3D models.ResultsThis study included two patients who underwent sagittal split ramus osteotomy (SSRO) and two benign tumor patients who underwent segmental mandibulectomy and immediate reconstruction. For each SSRO case, the mandibular condyles were designed to be convex and the glenoid cavities were designed to be concave. For the benign tumor cases, the margins on the resection side, including the joint portions, were designed to be convex, and the resection margin was designed to be concave. The distance from the mandibular ramus to the tip of the maxillary canine, the angle created by joining the inferior edge of the orbit to the tip of the maxillary canine and the ramus, the angle created by the lines from the base of the mentum to the endpoint of the condyle, and the angle between the most lateral point of the condyle and the most medial point of the condyle were measured before and after simulations. Near-complete matches were observed for all items measured before and after model simulations of surgery in all jaw deformity and reconstruction cases.ConclusionsWe demonstrated that 3D models manufactured using our method can be applied to simulations and fully restore the position of the condyle without the need for special devices.
Highlights
Along with the advances in technology of three-dimensional (3D) printer, it became a possible to make more precise patient-specific 3D model in the various fields including oral and maxillofacial surgery
When creating 3D models of the mandible and maxilla, it is easier to make a single unit with a fused temporomandibular joint, though this results in poor operability of the model and when bending reconstructive plates
Measurements The distance from the mandibular ramus to the tip of the maxillary canine, the angle created by joining the inferior edge of the orbit (Or) to the tip of the maxillary canine and the ramus, the angle created by the lines from the base of the mentum (Me) to the endpoint of the condyle (CE), and the angle between the most lateral point of the condyle (LC) and the most medial point of the condyle (MC) [4] were measured before and after simulations by three certified oral surgeons (Fig. 2a–c)
Summary
Along with the advances in technology of three-dimensional (3D) printer, it became a possible to make more precise patient-specific 3D model in the various fields including oral and maxillofacial surgery. When creating 3D models of the mandible and maxilla, it is easier to make a single unit with a fused temporomandibular joint, though this results in poor operability of the model. While models created with a separate mandible and maxilla have operability, it can be difficult to fully restore the position of the condylar after simulation. In the field of oral and maxillofacial surgery, many institutions have recently begun using three-dimensional (3D) printers to create 3D models of a variety of diseases. When creating 3D models of the mandible and maxilla, it is easier to make a single unit with a fused temporomandibular joint, though this results in poor operability of the model and when bending reconstructive plates. While models created with a separate mandible and maxilla have good operability, it can be difficult to fully restore the position of the mandibular condyle after simulations.
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