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Author(s):
Philipp Kupfer DMD MD, Nariman Saadat DMD MD, Pamela Hughes DDS.
Oral and Maxillofacial Surgery, Oregon Health and Science University
Purpose: The purpose of this abstract is to describe the reconstruction of a bilateral atrophic mandible fracture with malunion with the help of virtual surgical planning and custom cutting guides and reconstruction plate.
Materials and Methods: A 73-year-old woman presented to the Oregon Health and Science University Department of Oral and Maxillofacial Surgery with a history of having suffered an atrophic, edentulous mandible fracture treated with circumandibular wires using her pre-existing dentures for reduction while vacationing outside the USA. She presented to our Department seven months later with a left sided malunion and right sided non-union and posterior displacement of the distal mandibular segment. A CT scan was obtained and virtual surgical planning was used determine the location of the osteotomy, and the patient’s mandible and B point was re-projected virtually. Custom cutting guides and a custom reconstruction plate were designed virtually, fabricated and used to reconstruct the mandible.
Results: The patient was successfully treated with open reduction and internal fixation of her bilateral atrophic mandible fractures utilizing virtual surgical planning, custom cutting guides and custom reconstruction plate. Function was restored and the mandible was re-projected.
Conclusion: ORIF of the atrophic, edentulous mandible fracture with the help of virtual surgical planning can not only decrease surgical time as reported in the literature,but also makes the operation more predicable and can re-create mandibular projection.
References:
Clayman L, Rossi E: Fixation of atrophic edentulous mandible fractures by bone plating at the inferior border. J Oral Maxillofac Surg 70:883-889, 2012
Van Sickels J, DDS, Cunningham L: Management of atrophic mandible fractures: Are bone grafts necessary? J Oral Maxillofac Surg 68:1392-1395, 2010