The purpose of this study was to assess the 1-year skeletal stability of the osteotomized maxilla after Le Fort I surgery, comparing conventional osteosynthesis with patient-specific osteosynthesis. Patients were assigned to a conventional or patient-specific osteosynthesis group using prospective randomization. The primary outcome was the three-dimensional change in postoperative skeletal position of the maxilla between the 2-week and 1-year follow-up cone beam computed tomography scans. Fifty-eight patients completed the protocol for the 2-week postoperative analysis, and 27 patients completed the 1-year follow-up study protocol. Of the 27 patients completing the entire protocol, 13 were in the conventional group and 14 in the patient-specific osteosynthesis group. The three-dimensional translation analysis showed that the use of the patient-specific osteosynthesis resulted in a skeletally stable result, comparable to that of conventional miniplate fixation. For both the patient-specific osteosynthesis and conventional miniplate fixation groups, median translations of less than 1 mm and median rotations of less than 1° were observed, indicating that both methods of fixation resulted in a stable result for the 27 patients examined. For the Le Fort I osteotomy, the choice between patient-specific osteosynthesis and conventional osteosynthesis did not affect the postoperative skeletal stability after 1 year of follow-up.
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http://dx.doi.org/10.1016/j.ijom.2022.09.005 | DOI Listing |
Oral Maxillofac Surg
January 2025
Department of Oral and Maxillofacial Diseases, Helsinki University and Helsinki University Hospital, Helsinki, Finland.
Purpose: Preoperative virtual planning and osteosynthesis with patient-specific implants (PSIs) have become a quotidian approach to many maxillofacial elective surgery setups. When a process is well-organized, a similar approach can be harnessed to serve the needs of exact primary reconstructions, especially in midfacial trauma cases. PSI osteosynthesis of the mandible is, however, more challenging because a mirror technique of the facial sides is often unreliable due to inherent lack of symmetry, and movement of the mandible increases the risk of loosening of the osteosynthesis.
View Article and Find Full Text PDFJ Vet Dent
January 2025
Department of Dentistry, Oral and Maxillo-facial Surgery, Eastcott Veterinary Referrals, Part of Linnaeus Group, Swindon, UK.
Canine acanthomatous ameloblastoma (CAA) is an invasive benign epithelial odontogenic tumour most commonly affecting the mandible of large breed dogs. To the author's knowledge, this report describes the first computer-aided design patient-specific implant (PSI) that has been placed for a critical sized bone defect in mandibular reconstruction of a dog in the UK. The aim was to restore mandibular stability using a regenerative approach combining a titanium locking plate and compression-resistant matrix infused with recombinant human bone morphogenetic protein-2 (rhBMP-2) to bridge the 85 mm mandibular defect created by a segmental mandibulectomy.
View Article and Find Full Text PDFSci Rep
January 2025
Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Hanzeplein 1, P.O. Box 30.001, 9700 RB, Groningen, The Netherlands.
In cases of large mandibular continuity defects resulting from malignancy resection, the current standard of care involves using patient-specific/custom titanium reconstruction plates along with autogenous grafts (fibula, scapula, or iliac crest segments). However, when grafts are not feasible or desired, only the reconstruction plate is used to bridge the gap. Unfortunately, metal osteosynthesis and reconstruction plates, including titanium, exhibit adverse effects such as stress-shielding and limitations in accurate postoperative irradiation (especially with proton-beam therapy).
View Article and Find Full Text PDFBMC Musculoskelet Disord
December 2024
The Fourth Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China.
Background: Patellar fractures present challenges in treatment, with traditional methods often leading to complications such as loss of reduction and implant failure. This study aimed to compare a novel suture fixation technique with the traditional tension band method using finite element analysis.
Methods: CT images of a healthy 35-year-old male were used to construct 3D patellar models.
BMC Musculoskelet Disord
December 2024
Department of Traumatology, Hand Surgery and Sports Medicine, ViDia Clinics Karlsruhe, Steinhaeusserstr. 18, Karlsruhe, D-76135, Germany.
Purpose: The aim of the study was to determine preoperative patient- and fracture-related risk factors for estimating the risk of fracture sequelae after surgically treated proximal humerus fractures (PHF) using locking plate osteosynthesis. The purpose was to develop a fracture sequelae risk score as an additional tool to facilitate the treatment strategy for PHF.
Methods: All patients with PHF who underwent surgery with locking plate osteosynthesis were included.
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