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Novel Technique and Step-by-Step Construction of a Computer-Guided Stent for Mandibular Distraction Osteogenesis

Hany, Hossam El-Dien MDS; El Hadidi, Yasser Nabil MOMSRCSEd; Sleem, Heba PhD; Taha, Moustafa PhD; El Kassaby, Marwa PhD

doi: 10.1097/SCS.0000000000005614
Technical Strategies
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Introduction: Distraction osteogenesis is an integral part in management of mandibular defects associated with hemifacial microsomia and post-ankylotic mandibular defects. The most difficult part in distraction osteogenesis is the prediction of distraction vector and risk of injury to vital structures as inferior alveolar. The present study aimed to present 3-dimensionally constructed computer-guided splints in distraction osteogenesis to get an ideal vector and minimal risk of vital structures injury.

Material and Methods: The technical note presents cases series of 6 patients who had computer-guided distraction osteogenesis surgery using prefabricated splints.

Results: The distance between the virtual and physical pins and osteotomy was measured, and the deviation of the vector angle and osteotomy angle was also assessed. Average deviation in pin distance was 3 mm and in vector angle 13.5°. Average deviation in osteotomy distance was 2.6 mm and in osteotomy angle 14.4°. None of the cases had injury to vital structure. There was significant improvement (P = 0.0078) in the medial canthus–buccal commissure distance where the arithmetic mean improved from 59.6 (SD = 10.1) mm pre-distraction in the defective side to 67.1 (SD = 8) mm post-distraction. The degree of correction was 97% compared to the normal side.

Conclusion: 3D printed surgical stents were successful in transferring the virtual treatment plan of mandibular distraction osteogenesis into the surgical theatre with an acceptable margin of error and without injury to any vital structures

Oral and Maxillofacial Surgery, Faculty of Dentistry, Ain Shams University, Cairo, Egypt.

Address correspondence and reprint requests to Yasser Nabil El Hadidi, MOMSRCSEd, Associate Lecturer of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ain Shams University, Cairo, Egypt; E-mail: yasserelhadidi@asfd.asu.edu.eg

Received 20 February, 2019

Accepted 31 March, 2019

The authors report no conflicts of interest.

Supplemental digital contents are available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www.jcraniofacialsurgery.com).

© 2019 by Mutaz B. Habal, MD.