Abstract
Mandibular fractures lead to changes in occlusion, aesthetic deformities and functional alterations, when untreated, their sequelae may cause permanent problems, leading to a more complex treatment than the acute trauma. The treatment offers challenges that can be minimized with the aid of biomodels, printed by 3D technology. This article aims to report a biomodel-assisted surgical procedure for mandibular reconstruction, arguing how these prototypes may help to achieve better outcomes. The patient was involved in an automobile accident and sought treatment for the sequelae of mandibular fractures two years after the initial trauma. The biomodel printing of her mandible allowed for the execution of surgery on the model, reestablishing correct occlusion and facial aesthetics, and helping shorten the surgical time through the pre-bending of reconstruction plates. The patient improved uneventfully. The use of biomodels must be encouraged, especially in cases where the patient shows sequelae, when the anatomical landmarks are compromised, they offer more predictability for treatment outcomes, as described on this case report.
Highlights
Facial trauma is a common cause of attendance to emergency rooms worldwide
The patient underwent the whole treatment in the public health system, undergoing hospitalization, multiple surgeries and postoperative physiotherapy for a hip fracture correction, the whole treatment process postponed specialized care for the mandibular fractures (MF)
One of the major problems was the lack of adequate mandibular function, leading to fibrosis, muscle and ligament atrophy that needed to be reversed with the help of postoperative physiotherapy, in addition to an extensive Bristow maneuver during the surgery
Summary
Facial trauma is a common cause of attendance to emergency rooms worldwide. According to most epidemiological surveys, the mandible and nasal bones are the most affected (Miloro, et al 2016; Ruela et al, 2018). Functional limitation, dysphagia, occlusal changes and facial deformities, which is why, in most cases, surgical treatment is necessary (Pickrell & Hollier, 2017). The main goal is to reestablish the occlusion and mandibular contour through precise reduction of the bone segments. The ideal reduction may be difficult due to complex fracture patterns, muscle action that favors displacement and time elapsed between the trauma and the surgical procedure (Ramanathan et al, 2020). Stable internal fixation is the technique of choice for simple fractures, while rigid internal fixation is indicated in cases of comminuted fractures or when segmental defects are present. The rigid fixation seeks to reestablish the original mandibular contour and serves as a frame for bone reconstruction (Zaylin et al 2018; Wusiman, Tayie & Ling, 2019.)
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