Computer assisted mandibular reconstruction using a custom-made titan mesh tray and removable denture based on the top-down treatment technique

详细信息    查看全文

• 作者：Tomoko Ikawa ; DDS ; PhD^a ; Yuko Shigeta ; DDS ; PhD^a ; ^{shigeta-y@tsurumi-u.ac.jp" class="auth_mail" title="E-mail the corresponding author} ; Rio Hirabayashi ; DDS ; PhD^a ; Shinya Hirai ; DDS ; PhD^a ; Kentaro Hirai ; DDS^a ; Naohiko Harada ; DT^b ; Noboru Kawamura ; DT^b ; Takumi Ogawa ; DDS ; PhD^a
• 关键词：Mandibular reconstruction ; Custom-made titan mesh tray ; Top-down treatment technique ; Particulate cancellous bone and marrow ; Computer tomography
• 刊名：Journal of Prosthodontic Research
• 出版年：2016
• 出版时间：October 2016
• 年：2016
• 卷：60
• 期：4
• 页码：321-331
• 全文大小：3706 K

文摘

The purpose of this report is to propose a computer assisted mandibular reconstruction procedure, utilizing a custom-made Ti-mesh tray with particulate cancellous bone and marrow, and a removable denture. This procedure was based on the top-down treatment technique, and reviews the case of a representative patient with mandibular continuity defect.

Methods

The patient was a 74-year old female with a chief complaint of facial asymmetry and masticatory dysfunction. Due to gingival carcinoma, she underwent a segmental mandibulectomy on the left mandibule.

On the VR space, using 3-D reconstructed computer tomography data, the residual right-side mandibular fragment was repositioned based on the condylar position and the occlusal relation. The mandibular fragment was then mirrored for a central sagittal plane. The position of the mirrored object was slightly arranged with the occlusal relation. Through the above operations, the landmark configuration, for the custom-made Ti-mesh tray as a virtual simulation model, was fabricated. On the physical model, we produced a custom-made Ti-mesh tray with a commercial Ti-mesh sheet. Surgical treatment was carried out using the tray.

The denture pattern was designed by a dental technician on the VR space, fabricated using a 3D printer, and modified to create an impression tray with resin. Using the impression, the temporary removable denture was fabricated.

Conclusions

We propose a computer assisted design for a custom-made Ti-mesh tray and a removable denture, based on the Top-down treatment concept. We feel this technique is advantageous in reconstructing functional occlusion, and in accurately regaining dental and facial esthetics.