Assessment of cone-beam CT technical image quality indicators and radiation dose for optimal STL model used in visual surgical planning.

Objectives: The aim of this study was to identify cone-beam computed tomography (CBCT) protocols that offer an optimal balance between effective dose (ED) and 3D model for orthognathic virtual surgery planning, using CT as a reference, and to assess whether such protocols can be defined based on technical image quality metrics.

Methods: Eleven CBCT (VISO G7, Planmeca Oy, Helsinki, Finland) scan protocols were selected out of 32 candidate protocols, based on ED and technical image quality measurements. Next, an anthropomorphic RANDO SK150 phantom was scanned using these 11 CBCT protocols and 2 CT scanners for bone quantity assessments.

The Frequency of Temporomandibular Disorders, Surgical Complications, and Self-Reported Mental Health Problems in Orthognathic Patients.

Objective: To evaluate the frequency of signs and symptoms of temporomandibular disorders (TMD), surgical complications, and patient's self-reported mental health problems during orthognathic treatment.

Material And Methods: The clinical records of 145 patients treated with orthognathic treatment were retrospectively studied. Variables regarding occlusal parameters, treatment duration, TMD symptoms, complications, and self-reported mental health status at time points of T0 (beginning of the treatment), T1 (before surgery), and T2 (final examination) were evaluated.

Surgical Treatment of Cherubism With the Use of ThreeDimensional Virtual Planning and CAD-CAM Resection Guides: A Case Report and Systematic Literature Review.

We report the use of a three-dimensional virtual surgical planning technique including both fusion and superimposition to obtain harmony and symmetry of the face in an 18-year-old woman suffering from cherubism. The treatment contained several threedimensional techniques that allowed precise planning and a predictable surgical outcome. The reduction plasty was successful, and the postoperative healing was uneventful.

Virtual Surgical Planning Combined With Intraoperative Navigation in Mandibular Bilateral Sagittal Split Osteotomy for Accurate Placement of Patient Specific Implants.

The aim of the study is to evaluate clinical methods to obtain a significantly improved fitting of patient specific implants (PSI) in bilateral sagittal split osteotomies and to evaluate the use of electromagnetic navigation as a potential guide for condyle positioning. A prospective study using (1) a solid bite registration index during preoperative computed tomography, (2) critical planning with regard to the condylar rotation, (3) a piezoelectric saw throughout the mandibular osteotomy, and (4) intraoperative navigation to determine the position of the PSIs and the mandibular segments intraoperatively was performed. Ten patients were treated.

No differences in infections between patient-specific implants and conventional mini-plates in mandibular bilateral sagittal split osteotomy - Up to 3-year follow-up.

The use of individually designed osteotomies, combined with individually manufactured osteosynthesis material, is rapidly becoming a standard for more challenging maxillofacial surgery. The benefits of patient-specific implants (PSI) in orthognathic surgery are clear in complex cases. PSIs can enhance precision and ease up the surgical protocol.

Comparison of postoperative skeletal stability of maxillary segments after Le Fort I osteotomy, using patient-specific implant versus mini-plate fixation.

Background: Three-dimensionally (3D) designed osteotomies and customised osteosynthesis are rapidly becoming standard in maxillofacial reconstructive and deformity surgery. Patient-specific implants (PSIs) have been in use for a few years in orthognathic surgery as well. In Le Fort I osteotomy, wafer-free fixation of the maxillary segment can be performed by individually manufactured cutting and drill guides together with PSIs.

Comparison between patient specific implants and conventional mini-plates in Le Fort I osteotomy with regard to infections: No differences in up to 3-year follow-up.

Individually designed osteotomies and milled or printed patient-specific osteosynthesis materials are rapidly becoming a standard in maxillofacial reconstructive surgery. The benefits of using patient-specific implants (PSIs) in orthognathic surgery are especially clear in complex cases, and for this reason they are rapidly becoming common practice. We have earlier reported the benefits related to the use of PSIs as reposition and fixation system in Le Fort I osteotomy.

Surgical Treatment of Dentofacial Deformities Caused by Juvenile Idiopathic Arthritis.

The purpose of our retrospective study was to evaluate the results of orthognathic treatment, distraction osteogenesis, and/or prosthetic reconstruction of the temporomandibular joints in patients with juvenile idiopathic arthritis (JIA).Twelve patients with severely affected temporomandibular joints (TMJs) and reduced ramus height were treated with mandibular advancement with orthognathic surgery (11) and additional bilateral or unilateral mandibular ramus distraction (3) or additional bilateral or unilateral prosthetic reconstruction of the TMJ (3). One patient was treated surgically with bilateral TMJ prosthetic reconstruction only.

Osteotomy Site Grafting in Bilateral Sagittal Split Surgery With Bioactive Glass S53P4 for Skeletal Stability.

In orthognathic surgery, the aim of the treatment is to achieve a good occlusion and a satisfying aesthetic outcome. In large mandibular advancements insufficient healing at the mandibular inferior border may lead to loss of support for the overlaying tissue at the osteotomy site. Augmentation can be performed to improve stability, bone regeneration, and the aesthetic outcome.

Craniofacial and Dental Features in Six Children With Cherubism.

Cherubism is an autosomal-dominant benign bone disorder, characterized by fibro-osseous lesions in the mandible and maxilla commonly caused by mutations in the SH3-binding protein 2-gene. The purpose of the authors' study was to analyze craniofacial and dental features of children diagnosed with cherubism, describe their treatment, and assess their dental age compared with norms for Finnish children. Six children were diagnosed, followed up and treated due to dental and skeletal disorders caused by cherubsim.

Regeneration of Cystic Bone Cavities and Bone Defects With Bioactive Glass S53P4 in the Upper and Lower Jaws.

Cysts and tumors are common lesions in the jaws. To be able to retain a good volume of the alveolar ridge during healing as well as strengthening the angle and body of the mandible and provide an instant improved support for adjacent teeth, reliable long-term bone regeneration is needed. The purpose of this prospective study was to promote bone regeneration by filling bony defects in the upper or lower jaw with granules of the bioactive glass S53P4 (BAG), which have osteostimulative and antimicrobial properties.

The use of patient-specific implants in orthognathic surgery: A series of 30 mandible sagittal split osteotomy patients.

Purpose: Virtual surgery combined with patient-specific saw and drill guides and osteosynthesis materials are rapidly spreading from reconstructive surgery to orthognathic surgery. Most commercial partners are already providing computer-aided design and computer-aided manufacture (CAD/CAM) wafers and patient-specific saw guides. Clear benefits have been demonstrated for custom-made drill guides combined with individually designed three-dimensional (3D) printed patient-specific implants (PSI) as a reposition and fixation system in Le Fort I osteotomy.

Rapid prototyped patient specific guiding implants in critical mandibular reconstruction.

Large tumours of the mandible need immediate reconstruction to provide continuity of the mandible, satisfactory function of the jaw, as well as an acceptable aesthetic outcome. In this prospective study we described the immediate reconstruction of the mandible using computer aided design and 15 rapid prototyped patient specific implants (PSI) in 14 patients suffering from benign or malignant tumours demanding continuity resection of the mandible. The scaffold PSI was filled with β-tricalcium phosphate granules and autologous bone.

The use of patient-specific implants in orthognathic surgery: A series of 32 maxillary osteotomy patients.

The use of virtual surgery, patient-specific saw and drill guides, and custom-made osteosynthesis plates is rapidly spreading from deformity surgery to orthognathic surgery. Most of the commercially available systems are using computer-aided design/computer-aided manufacture (CAD/CAM) wafers to produce patient-specific saw guides. However, most plate systems provided are still the conventional "in stock" mini plates that can be individually designed by pre-bending according to the stereolithographic model of the patient.

Rapid prototyping modelling in oral and maxillofacial surgery: A two year retrospective study.

Background: The use of rapid prototyping (RP) models in medicine to construct bony models is increasing.

Material And Methods: The aim of the study was to evaluate retrospectively the indication for the use of RP models in oral and maxillofacial surgery at Helsinki University Central Hospital during 2009-2010. Also, the used computed tomography (CT) examination - multislice CT (MSCT) or cone beam CT (CBCT) - method was evaluated.

Rapid prototyped patient specific implants for reconstruction of orbital wall defects.

Defects of orbital walls can be reconstructed using implants. The authors report a safe and accurate method to reconstruct bone defects in the orbital area using patient specific implants. A detailed process description of computer aided design (CAD) reconstructive surgery (CRS) is introduced in this prospective study.

Increase in VEGF secretion from human fibroblast cells by bioactive glass S53P4 to stimulate angiogenesis in bone.

Bioactive glasses (BAGs) are being investigated for the repair and reconstruction of bone defects, as they exhibit osteoconductive and osteostimulatory potential. However, successful bone regeneration requires also the neovascularization of the construct which is, among other factors, guided by vascular endothelial growth factor (VEGF). In this study, BAG S53P4 (53% SiO2 , 23% Na2 O, 20% CaO, 4% P2 O5 ) is investigated in relation to VEGF-release and response of fibroblast cells.

Bioactive glass S53P4 in the filling of cavities in the mastoid cell area in surgery for chronic otitis media.

Objectives: Chronic infection of the middle ear and cholesteatoma can be treated surgically by exenteration of the mastoid air cells behind the ear. After a procedure with the canal wall-down technique, a cavity remains that is sometimes difficult to clean, collects crust, and becomes repeatedly infected. Such problematic mastoid cavities can be eliminated by filling the created cavity surgically after thorough removal of mucous membranes and cleaning of the bone.

Bioactive glass and turbinate flaps in the repair of nasal septal perforations.

Interpositional grafts between mucoperiosteal flaps are commonly used in the repair of septal perforations. We studied the use of bioactive glass (BAG) S53P4 as an interpositional graft and the use of turbinate flaps in 23 patients with septal perforations. Another 16 patients were treated with mucoperiosteal flaps only.