A selective laser sintering guide for transferring a virtual plan to real time surgery in composite mandibular reconstruction with free fibula osseous flaps

• Published in: International journal of oral and maxillofacial surgery Vol. 38; no. 2; pp. 187 - 192
• Main Authors: Leiggener, C, Messo, E, Thor, A, Zeilhofer, H.-F, Hirsch, J.-M
• Format: Journal Article
• Language: English
• Published: Kidlington Elsevier Ltd 01-02-2009; Elsevier
• Subjects: Aged; Biological and medical sciences; Computer-Aided Design; Dentistry; Female; Fibula - transplantation; free fibula osseous flaps; Humans; Imaging, Three-Dimensional - instrumentation; Lasers; Mandible - surgery; mandibular reconstruction; Medical sciences; MEDICIN; MEDICINE; Osteotomy - instrumentation; Osteotomy - methods; Otorhinolaryngology. Stomatology; Patient Care Planning; Prosthesis Design - instrumentation; Prosthesis Design - methods; Reconstructive Surgical Procedures - instrumentation; Reconstructive Surgical Procedures - methods; Selective Laser Sintering (SLS); Surgery; Surgery, Computer-Assisted - instrumentation; Surgery, Computer-Assisted - methods; Surgical Flaps; virtual planning; virtual planning; Selective Laser Sintering (SLS); mandibular reconstruction; free fibula osseous flaps; Mandible; Fibula; Guide; Stomatology; Anatomical reconstruction; Real time; virtual planning: mandibular reconstruction; Treatment; Surgery; Free flap; Laser; Planning
• ISSN: 0901-5027; 1399-0020; 1399-0020
• DOI: 10.1016/j.ijom.2008.11.026

Abstract The free fibular flap is the standard procedure for reconstructing mandibular defects. The graft has to be contoured to fit the defect so preoperative planning is required. The systems used previously do not allow transfer of the surgical plan to the operation room in an optimal way. The authors present a method to bring the virtual plan to real time surgery using a rapid prototyping guide. Planning was conducted using the Surgicase CMF software simulating surgery on a workstation. The osteotomies were translated into a rapid prototyping guide, sterilised and applied during surgery on the fibula allowing for the osteotomies and osteosynthesis to be performed with intact circulation. During reconstruction the authors were able to choose the best site for the osteotomies regarding circulation and as a result increased the precision and speed of treatment.