APPLICATION OF THREE-DIMENSIONAL PRINTING TECHNIQUE IN CORRECTION OF MANDIBULAR PROGNATHISM_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

ZHUMing , CHAIGang ,  LIQingfeng

Department of Plastic and Reconstruction Surgery, Shanghai 9th People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, 200011, P. R. China;

Corresponding author：

LIQingfeng, Email: dr.liqingfeng@yahoo.com

Keywords：

Three-dimensional printing technique; Mandibular prognathism; Sagittal split ramous osteotomy; Prefabricated titanium plate

DOI：

10.7507/1002-1892.20140067

Video：

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Objective To establish a method to prefabricate titanium plate with three-dimensional (3-D) printing technique for correction of mandibular prognathism in sagittal splint ramous osteotomy (SSRO). Methods Between January 2012 and May 2013, 12 patients with mandibular prognathism (Angle III malocclusion) were treated. Among them, 9 cases were male and 3 cases were female. Their ages ranged from 19 to 35 years (mean, 25.6 years). With the 3-D facial CT data of these patients, 3-D printer was used to print the models for preoperational simulation. SSRO was performed on 3-D models, and the titanium plates were prefabricated on the models after the distal segments were moved backward and rotated according to occlusal splint. During operations, the proximal segments were fixed to distal segments by the prefabricated titanium plates. 3-D CT scans were taken to examine the temporomandibular joint position changes before operation and at 6 months after operation. Results The skull models were manufactured by 3-D printing technique, and the titanium plates were reshaped on the basis of them. Twenty-four prefabricated titanium plates were placed during operations, and they all matched with the bone segments well. Evaluation of 3-D CT scans showed that the temporomandibular joint position had no change. All patients were followed up 7-12 months (mean, 10.6 months). The face type and dental articulation were improved greatly. All cases obtained satisfactory opening function and occlusion. Conclusion With the titanium plate fabricated based on 3-D models, surgeons are able to improve or refine surgical planning so that the operation can be performed according to preoperative simulation precisely and the complications, such as dislocation of temporomandibular joint, can be prevented.

Citation： ZHUMing, CHAIGang, LIQingfeng. APPLICATION OF THREE-DIMENSIONAL PRINTING TECHNIQUE IN CORRECTION OF MANDIBULAR PROGNATHISM. Chinese Journal of Reparative and Reconstructive Surgery, 2014, 28(3): 296-299. doi: 10.7507/1002-1892.20140067 Copy

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2.	Costa F, Robiony M, Poloti M. Stability of sagittal split ramus osteotomy used to correct Class III malocclusion:review of the literature. Int J Adult Orthodon Orthognath Surg, 2001, 16(2):121-129.
3.	Panula K, Finne K, Oikarinen K. Incidence of complications and problems related to orthognathic surgery:a review of 655 patients. J Oral Maxillofac Surg, 2001, 59(10):1128-1137.
4.	Bell WH, Yamaguchi Y, Poor MR. Treatment of temporomandibular dysfunction by intraoral vertical ramus osteotomy. Int J Adult Orthodon Orthognath Surg, 1990, 5(1):9-27.
5.	Hu J, Wang D, Zou S. Effects of mandibular setback on the temporomandibular joint:a comparison of oblique and sagittal split ramus osteotomy. J Oral Maxillofac Surg, 2000, 58(4):375-380.
6.	Will LA, Joondeph DR, Hohl TH, et al. Condylar position following mandibular advancement:its relationship to relapse. J Oral Maxillofac Surg, 1984, 42(9):578-588.
7.	Ueki K, Moroi A, Sotobori M, et al. A hypothesis on the desired postoperative position of the condyle in orthognathic surgery:a review. Oral Surg Oral Med Oral Pathol Oral Radiol, 2012, 114 (5):567-576.
8.	Ueki K, Nakagawa K, Marukawa K, et al. Stress change on the temporomandibular joint in mandibular prognathism subjects with asymmetry after orthognathic surgery. Eur J Orthod, 2010, 32(5):522-529.
9.	Kim YI, Jung YH, Cho BH, et al. The assessment of the short- and long-term changes in the condylar position following sagittal split ramus osteotomy (SSRO) with rigid fixation. J Oral Rehabil, 2010, 37(4):262-270.
10.	Yang HJ, Lee WJ, Yi WJ, et al. Interferences between mandibular proximal and distal segments in orthognathic surgery for patients with asymmetric mandibular prognathism depending on different osteotomy techniques. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2010, 110(1):18-24.
11.	Scans EM, Haggerty JS, Cima MJ, et al. Three-dimensional printing technique:US, 5204055[P]. 1993-04-20.
12.	Arvier JF, Barker TM, Yau YY, et al. Maxillofacial biomodelling. Br J Oral Maxillofac Surg, 1994, 32(5):276-283.
13.	Lin CC, Lo LJ, Lee MY, et al. Craniofacial surgical simulation:application of three-dimensional medical imaging and rapid prototyping models. Chang Gung Med J, 2001, 24(4):229-238.
14.	Lo LJ, Chen YR. Three-dimensional computed tomography imaging in craniofacial surgery:morpho-logical study and clinical applications. Chang Gung Med J, 2003, 26(1):1-11.
15.	Stoker NG, Mankovith NJ, Valentino D. Stereolithographic models for surgical planning:preliminiary report. J Oral Maxillofac Surg, 1992, 50(5):466-471.
16.	D'Urso PS, Barker TM, Earwaker WJ, et al. Stereolithographic bio-modelling in cranio-maxillofacial surgery:a prospective trial. J Craniomaxillafac Surg, 1999, 27(1):30-37.
17.	Levine JP, Patel A, Saadeh PB, et al. Computer-aided design and manufacturing in craniomaxillofacial surgery:the new state of the art. J Craniofac Surg, 2012, 23(1):288-293.
18.	王明君, 苗卫东, 张韶民, 等. 预制模板法塑形钛板内固定治疗髋臼骨折. 实用骨科杂志, 2008, 14(9):551-552.
19.	Raza SM, Thai QA, Pradilla G, et al. Frontozygomatic titanium cranioplasty in frontosphenotemporal ("pterional") craniotomy. Neurosurgery, 2008, 62(3 Suppl 1):262-264.

1. 张震康. 正颌外科学. 北京:人民卫生出版社, 1994:2-7.
2. Costa F, Robiony M, Poloti M. Stability of sagittal split ramus osteotomy used to correct Class III malocclusion:review of the literature. Int J Adult Orthodon Orthognath Surg, 2001, 16(2):121-129.
3. Panula K, Finne K, Oikarinen K. Incidence of complications and problems related to orthognathic surgery:a review of 655 patients. J Oral Maxillofac Surg, 2001, 59(10):1128-1137.
4. Bell WH, Yamaguchi Y, Poor MR. Treatment of temporomandibular dysfunction by intraoral vertical ramus osteotomy. Int J Adult Orthodon Orthognath Surg, 1990, 5(1):9-27.
5. Hu J, Wang D, Zou S. Effects of mandibular setback on the temporomandibular joint:a comparison of oblique and sagittal split ramus osteotomy. J Oral Maxillofac Surg, 2000, 58(4):375-380.
6. Will LA, Joondeph DR, Hohl TH, et al. Condylar position following mandibular advancement:its relationship to relapse. J Oral Maxillofac Surg, 1984, 42(9):578-588.
7. Ueki K, Moroi A, Sotobori M, et al. A hypothesis on the desired postoperative position of the condyle in orthognathic surgery:a review. Oral Surg Oral Med Oral Pathol Oral Radiol, 2012, 114 (5):567-576.
8. Ueki K, Nakagawa K, Marukawa K, et al. Stress change on the temporomandibular joint in mandibular prognathism subjects with asymmetry after orthognathic surgery. Eur J Orthod, 2010, 32(5):522-529.
9. Kim YI, Jung YH, Cho BH, et al. The assessment of the short- and long-term changes in the condylar position following sagittal split ramus osteotomy (SSRO) with rigid fixation. J Oral Rehabil, 2010, 37(4):262-270.
10. Yang HJ, Lee WJ, Yi WJ, et al. Interferences between mandibular proximal and distal segments in orthognathic surgery for patients with asymmetric mandibular prognathism depending on different osteotomy techniques. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2010, 110(1):18-24.
11. Scans EM, Haggerty JS, Cima MJ, et al. Three-dimensional printing technique:US, 5204055[P]. 1993-04-20.
12. Arvier JF, Barker TM, Yau YY, et al. Maxillofacial biomodelling. Br J Oral Maxillofac Surg, 1994, 32(5):276-283.
13. Lin CC, Lo LJ, Lee MY, et al. Craniofacial surgical simulation:application of three-dimensional medical imaging and rapid prototyping models. Chang Gung Med J, 2001, 24(4):229-238.
14. Lo LJ, Chen YR. Three-dimensional computed tomography imaging in craniofacial surgery:morpho-logical study and clinical applications. Chang Gung Med J, 2003, 26(1):1-11.
15. Stoker NG, Mankovith NJ, Valentino D. Stereolithographic models for surgical planning:preliminiary report. J Oral Maxillofac Surg, 1992, 50(5):466-471.
16. D'Urso PS, Barker TM, Earwaker WJ, et al. Stereolithographic bio-modelling in cranio-maxillofacial surgery:a prospective trial. J Craniomaxillafac Surg, 1999, 27(1):30-37.
17. Levine JP, Patel A, Saadeh PB, et al. Computer-aided design and manufacturing in craniomaxillofacial surgery:the new state of the art. J Craniofac Surg, 2012, 23(1):288-293.
18. 王明君, 苗卫东, 张韶民, 等. 预制模板法塑形钛板内固定治疗髋臼骨折. 实用骨科杂志, 2008, 14(9):551-552.
19. Raza SM, Thai QA, Pradilla G, et al. Frontozygomatic titanium cranioplasty in frontosphenotemporal ("pterional") craniotomy. Neurosurgery, 2008, 62(3 Suppl 1):262-264.

Chinese Journal of Reparative and Reconstructive Surgery

APPLICATION OF THREE-DIMENSIONAL PRINTING TECHNIQUE IN CORRECTION OF MANDIBULAR PROGNATHISM

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