JAPANESE JOURNAL OF ORAL & MAXILLOFACIAL SURGERY

Vol. 53 No. 10                   2007

ISSN: 0021-5163      UBIC: 151-J

ABSTRACT

Reproduction of the shape of the mandible is essential for restoring or creating functional occlusion and is a very important element for the preparation of dentures and implant prostheses. Mandibular reconstruction with a titanium mesh is suitable for restoring the physiological shape of the mandible, and either a cortical bone block or particulate cancellous bone and marrow can be used. However, it is difficult and time-consuming to fit and shape the titanium mesh during reconstructive surgery. To resolve this problem, we employed the following method. A craniofacial skull model was fabricated by means of the stereo-lithography technique on the basis of CT data. Preoperatively, a titanium mesh was bent and cut to simulate the original shape of the mandible on the model with simulated resection. This procedure made it easier to fit the titanium mesh after segmental resection while maintaining the shape of the mandible and shortened the operation time. Since titanium mesh does not need to be bent more than necessary, metal fatigue can be minimized. Furthermore, preoperative surgery simulation makes it possible to estimate the necessary amount of bone graft. This method contributed significantly to preoperative planning. All patients wore implant-supported fixed prostheses, and postoperative occlusal function and esthetics have been favorable. Key words: mandibular reconstruction, titanium mesh, three-dimensional skull model fabricated by means of the stereo-lithography technique, iliac bone, dental implant

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