3D Reconstruction of Mandibular Defects using CAD/CAM Designed Zirconia Prosthesis
Al- Anbar Medical Journal,
2019, Volume 15, Issue 2, Pages 24-29
AbstractBackground: Reconstruction of mandibular defects with autogenous free bone graft is considered the preferred method. However, the optimum reconstruction technique of mandibular defects is still controversial. Objectives: To assess the efficacy and safety of the zirconia individual designed CAD/CAM prosthesis for the mandibular reconstruction. Materials and methods: We used a new method (zirconia prosthesis) for the reconstruction of mandibular defects due to various causes. The study was carried out in the Oral and Maxillofacial Department of Al-Ramadi Teaching Hospital during a period of 62 months from January 2012 to March 2017. Data were collected for each patient regarding the age, gender, site and cause of the defect, investigations, operative technique, complications, outcome, and the duration of the follow-up. Results: Twenty patients, 14 were men and 6 women; the patients’ ages ranged from 19 to 70 years. The majority of the defects were caused by tumors, while, 40% due to congenital or traumatic causes. The success rate of the prosthesis taking was 95%. And in these cases, esthetic and functional outcomes were restored or improved after the reconstruction in all subjects. Conclusion: We described a novel method for mandibular reconstruction with zirconium individual-designed CAD/CAM model. We advise to use this method owing to the high success rate, the less major rate of complications in comparison with other methods, and high rate of functional and esthetic outcome.
Kamal T. AftanANB. MED. J. 15(2), 2019
rial because it is easier to be manufactured, appropriate me-
chanical strength with porous structure, and any errors can
be regulated during the processing .No local (cellular)
or systemic adverse reactions to the material were reported.
Another important issue concerning the zirconia: we can re-
place the missed teeth in patients who need replacement by
inserting zirconia dental implants in preoperatively prepared
holes.Unfortunately, those (7) patient who needed dental
replacement refused the dental implants at the time being.
rately fits a mandibular defect is possible by capturing and
transforming the geometry of the defect to precise three-
dimensional (3D) images using digital imaging systems, such
as CAD/CAM system.
The CAD modeling software process the data and converts
the actual bony defect into virtual model then the CAM tech-
nology transforms the data set into the desired model .
Recently, virtual surgical planning and computer-aided design
(CAD)/computer-aided modeling (CAM) are attractive and
well known methods in mandibular reconstruction and give
opportunities for increased accuracy, improved efficiency, and
enhanced outcomes .
CAD can be used to line osteotomy sites and measure the
dimension of bone segments by simulating the operative pro-
cess. Also before reconstruction, CAD can be used to provide
guidance for fabrication of accurate model for patient anatom-
ical defect.Through model surgical techniques, CAD/CAM
models, preoperative measured osteotomy guides, bite guides,
pre-bent plates, and other models have greatly improved the
accuracy of mandibular reconstruction surgeries .
The limitation of this study was the exclusion of malignant
tumors of mandible and patients with radiotherapy. Minimal
complications were reported after grafting of zirconia pros-
thesis such as mild pain, swelling. All of the patients (except
one) in this study did not report major complication such as
hematoma, infection and fracture of prosthesis.
We described a novel method for mandibular reconstruc-
tion with zirconium individual-designed CAD/CAM model.
It combines zirconia block with CAD/CAM techniques and
appropriate fixation which lead to improve the clinical out-
comes (facial esthetic and mandibular functions). We advise
to use this method for a large number of patients with differ-
ent causes of mandibular defects in the future studies.
CONFLICT OF INTEREST
The author declare that there is no conflict of interest.
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