Surgical Mini-Lectures and Clinics
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Friday, October 1, 2010
3:30PM - 5:30PM
S331
Computer Assisted Planning and the Rise of Surgical Guides in Maxillo-Mandibular Reconstruction
Handouts Not
Currently Available
Daniel Buchbinder, DMD, MD
Professor of Clinical Maxillofacial Surgery, Residency program directorAlbert Einstein College of Medicine, New York
New York, NY
Devin Joseph Okay, DDS
Director of Maxillofacial Prosthodontics,Continuum Cancer Center of New York
New York, NY
Synopsis
The combination of Medical Imaging and Rapid Prototyping is an expanding field with a large application potential in Cranio-maxillofacial reconstructive surgery. Typical applications include the making of three-dimensional models for treatment planning, the production of custom designed prostheses and the replication of segmental anatomical objects to guide the surgical and prosthodontic reconstructive efforts. When 3D visualization is combined with 3D surgery simulation and intra-operative navigation it becomes a powerful tool for precise and accurate surgical planning and execution of the restorative treatment plan. The use of CT derived surgical templates for implant placement have shown promise for restoring function within months after surgical reconstruction of acquired post-oncologic defects. A major advantage for CT derived surgical templates is the accuracy of implant placement into the greatest bone volume. This technique has demonstrated success in the edentulous population but has yet to be applied to management of the reconstructed mandible or maxilla with microvascular free flaps. We have found that implants can be placed into the neo-ridge without raising the soft tissue off the bony reconstruction or stripping the periosteal blood supply. A review of these techniques will be presented to demonstrate real value of computer assisted planning on the contemporary management of the patients with acquired and congenital craniomaxillofacial defects .
Learning Objectives
At the conclusion of this presentation, participants should be able to:
- Describe the need for rapid prototyping, modeling and computer assisted treatment planning in CMF reconstructive surgery;
- Describe the use of drilling/cutting guides in reconstructive CMF surgery; and
- Describe the use of computer assisted technology to avoid some of the complications associated with the treatment of this subset of reconstructed patients with less than ideal local conditions.