Application of CAD/CAM technology for surgical treatment of condylar head fractures: A preliminary study

Objectives: The aim of the present study was to improve the accuracy and reliability of ORIF in patients with condylar head fractures (CHFs) by developing a design for patient specific fixators, navigation and repositioning guides, as well as the algorithms of their clinical application. Materials a...

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Main Authors: Tetiana Pavlychuk, Denis Chernogorskyi, Yurii Chepurnyi, Andreas Neff, Andrii Kopchak
Format: Article
Language:English
Published: Elsevier 2020-10-01
Series:Journal of Oral Biology and Craniofacial Research
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2212426820301330
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author Tetiana Pavlychuk
Denis Chernogorskyi
Yurii Chepurnyi
Andreas Neff
Andrii Kopchak
author_facet Tetiana Pavlychuk
Denis Chernogorskyi
Yurii Chepurnyi
Andreas Neff
Andrii Kopchak
author_sort Tetiana Pavlychuk
collection DOAJ
description Objectives: The aim of the present study was to improve the accuracy and reliability of ORIF in patients with condylar head fractures (CHFs) by developing a design for patient specific fixators, navigation and repositioning guides, as well as the algorithms of their clinical application. Materials and methods: 14 patients with 16 CHFs were treated by ORIF with the use of CAD/CAM technology. After virtual reduction of the bony fragments, the appropriate length and diameter of the screws was chosen. In biomechanically unfavorable cases (type p) patient specific reinforcement plates were used together with the positional screws for reinforcement of the bone-fixator system. And in cases of severely comminuted fractures patient specific 3-D plate was applied. Results: The CT data, obtained immediately after the operation revealed the good anatomical reduction. Any deviations of the small fragments noted were near 1 mm in all cases. Postoperative clinical examination at 3 months follow up showed good occlusion and mouth opening not less than 3 cm in all patients. The lateral and anterior mobility of the mandible was restored with small limitations of protrusive mobility in 1 case. All the patients were satisfied with the outcomes. Conclusions: The application of the CAD/CAM technologies and the new design of the surgical guides and patient specific reinforcement plates for CHFs helps to improve the accuracy and quality of fragments reduction and stability of fixation with minimal risks of intraoperative complications. Clinical relevance: CAD/CAM technologies improve the clinical effectiveness of treatment patients with the CHFs.
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spelling doaj-art-d012f527f93e45ea9f7fed3fb69cf4002024-11-23T06:28:21ZengElsevierJournal of Oral Biology and Craniofacial Research2212-42682020-10-01104608614Application of CAD/CAM technology for surgical treatment of condylar head fractures: A preliminary studyTetiana Pavlychuk0Denis Chernogorskyi1Yurii Chepurnyi2Andreas Neff3Andrii Kopchak4Department of Stomatology, O.O. Bogomolets National Medical University, Kyiv, Ukraine; Corresponding author.Department of Stomatology, O.O. Bogomolets National Medical University, Kyiv, UkraineDepartment of Stomatology, O.O. Bogomolets National Medical University, Kyiv, UkraineDepartment of Oral and Craniomaxillofacial Surgery, UKGM GmbH, University Hospital Marburg and Philipps University Marburg, GermanyDepartment of Stomatology, O.O. Bogomolets National Medical University, Kyiv, UkraineObjectives: The aim of the present study was to improve the accuracy and reliability of ORIF in patients with condylar head fractures (CHFs) by developing a design for patient specific fixators, navigation and repositioning guides, as well as the algorithms of their clinical application. Materials and methods: 14 patients with 16 CHFs were treated by ORIF with the use of CAD/CAM technology. After virtual reduction of the bony fragments, the appropriate length and diameter of the screws was chosen. In biomechanically unfavorable cases (type p) patient specific reinforcement plates were used together with the positional screws for reinforcement of the bone-fixator system. And in cases of severely comminuted fractures patient specific 3-D plate was applied. Results: The CT data, obtained immediately after the operation revealed the good anatomical reduction. Any deviations of the small fragments noted were near 1 mm in all cases. Postoperative clinical examination at 3 months follow up showed good occlusion and mouth opening not less than 3 cm in all patients. The lateral and anterior mobility of the mandible was restored with small limitations of protrusive mobility in 1 case. All the patients were satisfied with the outcomes. Conclusions: The application of the CAD/CAM technologies and the new design of the surgical guides and patient specific reinforcement plates for CHFs helps to improve the accuracy and quality of fragments reduction and stability of fixation with minimal risks of intraoperative complications. Clinical relevance: CAD/CAM technologies improve the clinical effectiveness of treatment patients with the CHFs.http://www.sciencedirect.com/science/article/pii/S2212426820301330Condylar head fracturesCAD/CAM technologyPatient specific reinforcement platePSIScrew ostheosynthesys
spellingShingle Tetiana Pavlychuk
Denis Chernogorskyi
Yurii Chepurnyi
Andreas Neff
Andrii Kopchak
Application of CAD/CAM technology for surgical treatment of condylar head fractures: A preliminary study
Journal of Oral Biology and Craniofacial Research
Condylar head fractures
CAD/CAM technology
Patient specific reinforcement plate
PSI
Screw ostheosynthesys
title Application of CAD/CAM technology for surgical treatment of condylar head fractures: A preliminary study
title_full Application of CAD/CAM technology for surgical treatment of condylar head fractures: A preliminary study
title_fullStr Application of CAD/CAM technology for surgical treatment of condylar head fractures: A preliminary study
title_full_unstemmed Application of CAD/CAM technology for surgical treatment of condylar head fractures: A preliminary study
title_short Application of CAD/CAM technology for surgical treatment of condylar head fractures: A preliminary study
title_sort application of cad cam technology for surgical treatment of condylar head fractures a preliminary study
topic Condylar head fractures
CAD/CAM technology
Patient specific reinforcement plate
PSI
Screw ostheosynthesys
url http://www.sciencedirect.com/science/article/pii/S2212426820301330
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AT yuriichepurnyi applicationofcadcamtechnologyforsurgicaltreatmentofcondylarheadfracturesapreliminarystudy
AT andreasneff applicationofcadcamtechnologyforsurgicaltreatmentofcondylarheadfracturesapreliminarystudy
AT andriikopchak applicationofcadcamtechnologyforsurgicaltreatmentofcondylarheadfracturesapreliminarystudy