RESUMO
Segmental mandibulectomy is a treatment option for benign and malignant neoplasms of the mandible. Although reconstructing the mandible of a patient with a missing segment is difficult, it is essential to improve the postoperative course of the patient. Mandibular reconstruction using titanium mesh is a useful technique for dental implant placement because the morphology of the mandible can be easily reproduced. However, fitting titanium mesh to the remaining mandible is not an easy task during surgery. The present report introduces a method in which a 3-dimensional skull model fabricated by means of stereolithography is prepared, based on computerized tomography (CT) scans, to construct a titanium mesh cage matching the shape of the mandible, preoperatively. Furthermore, the load-bearing area of the titanium mesh cage is reinforced by laser welding another layer of titanium mesh to reduce the incidence of metal fatigue during jaw movement.
Assuntos
Materiais Biocompatíveis , Transplante Ósseo/métodos , Implantes Dentários , Soldagem em Odontologia/métodos , Lasers , Mandíbula/cirurgia , Procedimentos de Cirurgia Plástica/métodos , Telas Cirúrgicas , Titânio , Desenho Assistido por Computador , Desenho de Equipamento , Feminino , Humanos , Ílio , Imageamento Tridimensional , Neoplasias Mandibulares/cirurgia , Pessoa de Meia-Idade , Modelos Anatômicos , Mixoma/cirurgia , Planejamento de Assistência ao Paciente , Procedimentos de Cirurgia Plástica/instrumentação , Tomografia Computadorizada por Raios X , Transplante AutólogoRESUMO
PURPOSE: Maxillofacial prostheses are usually fabricated on the basis of impressions made with dental-impression material. The extent to which the prosthesis reproduces normal facial morphology depends on the clinical judgment of the individual fabricating the prosthesis. This paper describes a computer-aided design and manufacturing (CAD/CAM) system for the fabrication of maxillofacial prostheses. This system will provide a more consistently accurate reproduction of facial morphology. MATERIALS AND METHODS: Facial measurements were taken using a non-contact three-dimensional laser morphological measurement system. The measurements were sent to a computer numerical controlled (CNC) milling machine to generate a cast of the patient's face for the fabrication of prosthesis. RESULTS: Facial contours were measured using a laser. This method minimizes patient discomfort and avoids soft tissue distortion by impression material. Moreover, the digital data obtained is easy to store and transmit, and mirror-images can be readily generated by computer processing. CONCLUSION: This method offers an objective, quantified approach for fabricating maxillofacial prostheses.
