Considerations and Protocols in Virtual Surgical Planning of Reconstructive Surgery for More Accurate and Esthetic Neomandible with Deep Circumflex Iliac Artery Free Flap
김남규, 김현영, 김형준, 차인호, 남웅,
소속 상세정보
김남규 ( Kim Nam-Kyoo ) - Yonsei University College of Dentistry Department of Oral and Maxillofacial Surgery
김현영 ( Kim Hyun-Young ) - Yonsei University College of Dentistry Department of Oral and Maxillofacial Surgery
김형준 ( Kim Hyung-Jun ) - Yonsei University College of Dentistry Department of Oral and Maxillofacial Surgery
차인호 ( Cha In-Ho ) - Yonsei University College of Dentistry Department of Oral and Maxillofacial Surgery
남웅 ( Nam Woong ) - Yonsei University College of Dentistry Department of Oral and Maxillofacial Surgery
KMID : 1036320140360040161
Abstract
Purpose: The reconstruction of mandibular defects poses many difficulties due to the unique, complex shape of the mandible and the temporomandibular joints. With development of microvascular anastomosis, free tissue transplantation techniques, such as deep circumflex iliac artery (DCIA) flap and fibular free flap (FFF), were developed. The DCIA offers good quality and quantity of bone tissue for mandibular segmental defect and implant for dental rehabilitation. Virtual surgical planning (VSP) and stereolithography-guided osteotomy are currently successfully applied in three-dimensional mandibular reconstruction, but most use FFF. There are only a few articles on reconstruction with the DCIA that assess the postoperative results.
Methods: Three patients admitted during a five month period (April of 2013 to August of 2013) underwent resection of mandible and DCIA musculo-osseous reconstruction using a VSP and stereolithographic modeling and assessment of outcomes included technical accuracy, esthetic contour, and functional outcomes.
Results: This technique yielded iliac bone segment with excellent apposition and duplication of the preoperative plan. Flap survival was 100 percent and all patients maintained preoperative occlusion and contour.
Conclusion: Based on our experience, we offer considerations and logically consistent protocols by classification of mandibular defects, and demonstrate the benefits in VSP and stereolithographic modeling of mandibular reconstructive surgery with DCIA flap.
키워드
Mandibular reconstruction; Deep circumflex iliac artery flap; Virtual surgical planning; Stereolithographic models; Cutting guides
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