Instant rehabilitation of Brown Ⅱ maxilla defects with 3D printed prosthesis: a clinical preliminary study / 中华整形外科杂志

ABSTRACT

Objective@#To assess feasibility and clinical effect of 3D printed prosthesis in instant rehabitation of Brown Ⅱ maxilla defect.@*Methods@#Five patients with maxillary primary tumor or malignant tumor involving maxillary bone admitted from August 2016 to April 2017 were treated.Before surgery, surgical guide template and prosthesis was designed and created with digital surgery technique. Surgery was performed under guidance of surgical template and checked with surgical navigation. Prosthesis was also placed to repair Brown Ⅱ maxilla defect instantly in surgery.Two weeks after surgery, CBCT examination was taken and compared to the pre-operative CBCT images to evaluate deviation and assess precision of surgery. One month after surgery, 3D photograph was taken to compare intercommissural width, differences of bilateral lip height and maximum distance between healthy and affected sides of lip, nasolabial angles, skewed degree of mouth corner, volume variation and superficial area variation of the lip before and after insertion of prosthesis. All data ware analyzed with SPSS 21.0 using the Mann-Whitney U test for non parametric test.@*Results@#Prosthesis was inserted during 20 minutes in all 5 included patients with good occlusion. The suture was removed two weeks after surgery.The wound healed well without infection. 5 patients had no recurrence of tumor during follow-up.Maximum deviation between actual and virtual surgery was(3.75±0.87) mm, minimum deviation was 0 mm, and average deviation was(0.35±0.08) mm.The difference of bilateral lip height was(2.66±1.52) mm and(0.46±0.49) mm before and after insertion of prosthesis(P=0.016). The skewed degree of mouth corner was(3.43±1.70)°and(1.98±1.24)°before and after insertion of prosthesis(P=0.047). The maximum distance between healthy and affected sides of lip were(5.75±3.66) mm and(2.19±1.14) mm before and after insertion of prosthesis(P=0.009). The above differences were statistically significant.No significant differences were found between nasolabial angles and intercommissural width (P=0.251, 0.251). Volume variation before and after insertion of prosthesis was(5.54±2.50) cm3and superficial area variation was (66.42±21.18) cm2.@*Conclusions@#3D printed prosthesis can instantly repair Brown Ⅱ maxilla defect, retain facial appearance and dentition and obtain good effect.