Wednesday, September 14, 2011
4:00PM - 5:30PM
Steven G Press, DDS
Assistant Professor, Department of Oral and Maxillofacial Surgery
Vanderbilt University Medical Center
Adam T. Schaefer, DMD, MD
Customized Surgical Solutions is a program that consists of products and services that will enable surgeons to do more for their patients, by allowing the surgeon to preoperative plan the surgery, and transfer that plan to operating room with surgical guides, anatomic models, and customized implants.
Computer-aided Surgical Planning
New pre-operative planning software allows the surgeon to visualize the patient's anatomy and existing condition, and segment and manipulate the patient's skeletal anatomy to develop an optimum planned outcome. This new software provides the visualization and functionality for the surgeon to plan a variety of different surgical procedures, including mandible and maxillary reconstruction, orthognathics and distraction osteogenesis. The software provides the surgeon with specific functionality, or wizards, that will assist the surgeon during the virtual surgical simulation. These wizards include an osteotomy wizard for planning bone resections and a fibula wizard for optimizing the form and fit of a fibula graft. By using these functions, the surgeon can plan the position and angle of the osteotomies, and then optimize the final outcome by virtually creating and shaping the graft to best fit the patient.
This session will step the audience through the pre-operative planning workflow, from the patient's CT scan, through each of the pre-operative planning steps, to the final, virtually-planned outcome.
Surgical Guidance Instrumtation
For surgical procedures where exposure and visualization are possible, a physical, surgical guide can be used. The surgical guide is a patient specific, single-use instrument that directs the location and trajectory of drills and/or saws. Surgical guides help the surgeon perform an osteotomy, or locate an implant, as it was planned during the virtual planning session. The guide can also be an occlusal splint used to maintain occlusion of the teeth for orthognathic procedures. Specific features of the patient's skeletal anatomy or dentition are replicated in the guide to provide a secure and unique fit.
This session will describe the different types of surgical guides and how they are developed from the surgical plan. We also demonstrate how the guides are used to transfer the virtual surgical plan to the operating room.
Anatomic and Patient Specific Implants
Once the surgical plan is complete, Synthes provides a variety of implant options to meet the specific needs of the patient and surgeon. Based on the surgical plan, Synthes can provide an anatomic implant or a patient specific implant that best fit's the patient anatomy and the planned outcome. Synthes provides anatomic plates in a variety of sizes that fit the majority of patient's, including Preformed Mandible Plates, Preformed Orbital Floor Plates and Preformed Orthognathic Plates. If a more patient specific solution is required, then an implant can be designed to match the patients existing, or planned anatomy. These patient specific implants provide aesthetic results, reduced operating time, and improve accuracy as shown by postoperative error analysis. For cranial and midface reconstruction, a patient specific implant produced from PEEK or Titanium can be designed to fit the patient anatomy, providing matched contour with planned facial projection and width. For mandible reconstruction, a patient specific mandible plate can be fabricated based on the perfected, or mirrored, mandible, or the planned outcome mandible with, for example, a segmented fibula graft.
In this session, we will describe the different types of anatomic and patientspecific implants available from Synthes, and the process for requesting and developing these implants.