Surgical Site Adaptability and Outcomes of Patient Specific Implants used for the Reconstruction of Maxillofacial Defects: A Prospective Pilot Study
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Keywords
Reconstruction, maxillofacial defects, patient specific implants, adaptation
Abstract
Objectives: Major breakthrough in Craniofacial reconstructions emerged with the advent of Patient Specific Implants (PSI) which are designed with high precision and accuracy, leading to improved adaptability to such defects and a plethora of treatment options ranging from the reconstruction of simple alveolar defects to complex three-dimensional printing of maxilla or mandible en bloc. The aim of this study is to evaluate the surgical site adaptability and patient acceptance of patient specific implants used for reconstruction of maxillofacial defects.
Materials and Methods: This is a case series of patients operated in the Department of Oral and Maxillofacial Surgery of Saveetha Dental College. 3 patients with maxillofacial defects requiring reconstruction have been included. CBCT or CT analysis of the defects was done, based on which patient specific implants were designed using in - house Geomagic Freeform 3D designing software. Three-dimensional titanium printing of the designed implants was done in the in-house laboratory at Saveetha Dental College. Surgical procedure for placement was carried out. The variables assessed are the surgical site adaptability, postoperative VAS score, scale assessing the aesthetic result of the surgery and challenges faced intraoperatively.
Results: Prime advantage of patient specific implants is the surgical site adaptability achieved and the provision for future prosthetic rehabilitation. The mean VAS score was as follows: 1st day - 8.97, 3rd day - 6.5, 7th day - 3.5. The aesthetic rehabilitation score for the 1st and 3rd patient was 3.0 and the second patient was 4 (Chi-square test, p>0.05). The challenges observed were the need for additional soft tissue flaps in 2 cases, and the requirement to extend surgical site for access in large PSIs.
Conclusion: Patient specific implants prove to be an effective treatment option for reconstructing defects of maxillofacial skeleton owing to their superior surgical site adaptability and aesthetic outcomes.
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