Maxillofac Plast Reconstr Surg.  2018 ;40(1):4. 10.1186/s40902-018-0143-7.

Novel condylar repositioning method for 3D-printed models

Affiliations
  • 1Department of Oral Pathobiological Science and Surgery, Tokyo Dental College, 2-9-18 Kanda Misaki-cho, Chiyoda-ku, Tokyo, Japan. ksugahara@tdc.ac.jp
  • 2Oral Health Science Center, Tokyo Dental College, 2-9-18 Kanda Misaki-cho, Chiyoda-ku, Tokyo, Japan.
  • 3Department of Anatomy, Tokyo Dental College, 2-9-18 Kanda Misaki-cho, Chiyoda-ku, Tokyo, Japan.
  • 4Department of Oral and Maxillofacial Surgery, Tokyo Dental College, 2-9-18 Kanda Misaki-cho, Chiyoda-ku, Tokyo, Japan.

Abstract

BACKGROUND
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. 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.
METHODS
Our 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.
RESULTS
This 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.
CONCLUSIONS
We 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.

Keyword

Three-dimensional models; Condylar repositioning; Tumor resection; Orthognathic surgery

MeSH Terms

Chin
Congenital Abnormalities
Equidae
Glenoid Cavity
Humans
Jaw
Joints
Mandible
Mandibular Condyle
Mandibular Osteotomy
Maxilla
Methods*
Oral and Maxillofacial Surgeons
Orbit
Orthognathic Surgery
Osteotomy, Sagittal Split Ramus
Surgery, Oral
Temporomandibular Joint
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