In-House Digital Workflow for the Management of Acute Mandible Fractures

J Oral Maxillofac Surg. 2019 Oct;77(10):2084.e1-2084.e9. doi: 10.1016/j.joms.2019.05.027. Epub 2019 Jun 10.

Abstract

Computer-aided design and additive manufacturing are revolutionizing oral and maxillofacial surgery. Current methods use virtual surgical planning sessions and custom plate milling via third-party vendors, which is costly and time-consuming, negating the effectiveness in acute facial trauma. This technical note describes a state-of-the-art in-house expedited digital workflow for computer-aided virtual fracture reduction, 3-dimensional printing, and preoperative reconstruction plate adaptation for the management of an acute mandible fracture. This process uses the computed tomographic scan a patient receives in the emergency department or clinic. The DICOM (Digital Imaging and Communications in Medicine) data are transferred into US Food and Drug Administration-approved software, in which the fracture is segmented and virtually reduced based on condylar position, midline symmetries, and occlusion if present. The reduced mandible is then printed, which serves as a template for preoperative reconstruction plate adaptation. This method facilitates a virtually reduced fractured mandible, 3-dimensionally printed model, and ideally adapted plates ready for sterilization before surgery within 2 hours after DICOM upload.

MeSH terms

  • Bone Plates
  • Computer-Aided Design
  • Humans
  • Imaging, Three-Dimensional*
  • Mandible
  • Mandibular Fractures* / surgery
  • Printing, Three-Dimensional
  • Surgery, Computer-Assisted*
  • Workflow*