Multicenter study on the use of XXXX -specific CAD/CAM reconstruction plates for mandibular reconstruction.

@entity1 @entity702 @entity51879 @entity39
PURPOSE:   For the new generation of mandibular reconstruction, @entity1 -specific mandible reconstruction plates (PSMPs) have been developed which are milled from @entity702 after preoperative computer planning using CAD/CAM procedures. Resection margins and plate position are determined by surgical guides. In addition, length and shape of the plate and the number and angulation of the screw holes can be planned. METHODS:   30 @entity1 received such @entity51879 . Indication ranged from stabilization osteosynthesis, single alloplastic stand-alone reconstruction to microvascular reconstructions. Time for planning, fit of surgical guides and plates, pre-/postoperative occlusion, radiological position of the temporo mandibular joint and complications were recorded. RESULTS:   The median time for online planning was 35  min. The results concerning fit and handling of the @entity51879 and the surgical guides were mainly very positive. In six cases, the plan had to be adapted to the intraoperative clinical needs. The postoperative position of the condyles in the temporo mandibular fossae was regular in 28 cases. The evaluation of the occlusion was not representative due to not clearly identifiable occlusion in 2/3 of the cases. Nevertheless, complications like postoperative extraoral plate exposure, infection, graft and flap @entity39 or difficulties to position the guides or the plate during surgery occurred. CONCLUSIONS:   Mandibular reconstruction with @entity51879 offers a broad range of opportunities and benefits compared with standard procedures and can be recommended for all kind of mandibular reconstructions. It is not yet foreseeable whether @entity51879 will in future become routine clinical practice for mandibular reconstruction or will be confined to selected isolated cases.
