Abstract
The aim of this systematic review was to gather the clinical and laboratory applications of CAD/CAM technology for preoperative planning, designing of an attachment system, and manufacturing of nasal prostheses. According to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, an electronic search was carried out. Only human clinical studies involving digital planning for the rehabilitation of facial defects were included. A total of 21 studies were included with 23 patients, which were virtually planned through different planning software. The most common preoperative data for digital planning were CT scans in nine cases, CBCT in six cases, and laser scans in six cases. The reported planning softwares were Mimics in six cases, Geomagic Studio software in six cases, ZBrush in four cases, and Freeform plus software in four cases. Ten surgical templates were designed and printed to place 36 implants after digital planning, while post-operative assessment was done in two cases to check the accuracy of planned implants. Digital 3D planning software was reported for presurgical planning and craniofacial implants placement, fabrication of molds, designing of implants, designing of retentive attachments, and printing of silicone prostheses. Digital technology has been claimed to reduce the clinical and laboratory time; however, the equipment cost is still one of the limitations.
Highlights
Maxillofacial defects can be caused by genetic malformations, ablative tumor surgery, and trauma
As most of the advancement in virtual planning and printing software for maxillofacial rehabilitation has been seen since the last decade [18]; an initial search yielded
Since 1997, various systems for computer-guided implants placement have been available for intra-oral implants [42,43]; their use for craniofacial implants planning and placement has not been practiced until the last decade
Summary
Maxillofacial defects can be caused by genetic malformations, ablative tumor surgery, and trauma. These defects require immediate intervention to improve the quality of life of a patient [1,2,3]. Nasal defects most significantly affect the esthetics and psychology of patients due to their central location on the face. Treatment options to rehabilitate these patients include surgical reconstruction or prosthetic rehabilitation [4,5,6,7,8,9]. Surgical reconstruction can be done with a bilobed flap, nasolabial flap, forehead flap, septal mucosal flap, S-shaped rotation flap, croissant-shaped flaps, modified V-Y flaps, radial forearm free flaps, and titanium mesh [10]. Surgical reconstruction involving the entire nasal cavity poses significant challenge to reconstructive surgeons; it is currently only performed with satisfactory results in a few specialized medical centers
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