Can Fracture Reduction be Attempted Through a 3D-Printed Guide Template Without Maxillomandibular Fixation?

Humans Printing, Three-Dimensional Mandibular Fractures / diagnostic imaging Jaw Fixation Techniques Computer-Aided Design Fracture Fixation

Journal

Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons
ISSN: 1531-5053
Titre abrégé: J Oral Maxillofac Surg
Pays: United States
ID NLM: 8206428

Informations de publication

Date de publication:
08 2023
Historique:
received: 15 01 2023
revised: 20 04 2023
accepted: 01 05 2023
medline: 7 8 2023
pubmed: 24 5 2023
entrez: 23 5 2023
Statut: ppublish

Résumé

Computer-aided design and manufacturing (CAD/CAM) is widely used in clinical practice. This technology may change existing methods for mandibular fracture management. The purpose of this in-vitro study was to determine if the reduction for mandibular symphysis fracture can be performed without maxillomandibular fixation (MMF) using 3-dimensional (3D)-printed template. This in-vitro study was designed as a proof-of-concept. The sample was composed of 20 existing pairs of intraoral scan and computed tomography (CT) data. A mandibular model stereolithography (STL) file was created by merging the STL file obtained for the bimaxillary dentitions with the CT DICOM file, and this was set as the original model. Using the original model, a STL file of a fracture model of the mandibular symphysis was created using CAD. A template similar to a wafer or an implant guide was manufactured to restore original occlusion, and the mandibular fracture model was reduced and fixed using the 3D-printed template and wire. This was set as the experimental group. The 3D coordinate system error was measured at 6 landmarks and statistically compared using scan data between models of the groups. Reduction techniques with MMF or without MMF using guide template for mandibular fracture model. The 3D coordinate system error (mm). The position of landmarks. The Mann-Whitney U test, student's t-test, and the Kruskal-Wallis test were used to analyze the coordinate errors between the landmarks. A P value of < .05 was considered statistically significant. The 3D error value of the control and experimental group were 1.06 ± 0.63 mm (range: 0.11 to 2.92 mm) and 0.96 ± 0.48 mm (range: 0.2 to 2.95 mm), respectively. There was no statistical difference between the control and experimental group. There was a statistically significant difference in the lower 2 and lower 3 landmarks compared to the upper 1 (P = .001 and .000, respectively) before and after the reduction in the experimental group. This study demonstrates that the reduction using a 3D-printed guide template for the mandibular symphysis fracture could be possible even without the MMF.

Sections du résumé

BACKGROUND
Computer-aided design and manufacturing (CAD/CAM) is widely used in clinical practice. This technology may change existing methods for mandibular fracture management.
PURPOSE
The purpose of this in-vitro study was to determine if the reduction for mandibular symphysis fracture can be performed without maxillomandibular fixation (MMF) using 3-dimensional (3D)-printed template.
STUDY DESIGN, SETTING, AND SAMPLE
This in-vitro study was designed as a proof-of-concept. The sample was composed of 20 existing pairs of intraoral scan and computed tomography (CT) data. A mandibular model stereolithography (STL) file was created by merging the STL file obtained for the bimaxillary dentitions with the CT DICOM file, and this was set as the original model. Using the original model, a STL file of a fracture model of the mandibular symphysis was created using CAD. A template similar to a wafer or an implant guide was manufactured to restore original occlusion, and the mandibular fracture model was reduced and fixed using the 3D-printed template and wire. This was set as the experimental group. The 3D coordinate system error was measured at 6 landmarks and statistically compared using scan data between models of the groups.
PREDICTOR/EXPOSURE/INDEPENDENT VARIABLES
Reduction techniques with MMF or without MMF using guide template for mandibular fracture model.
MAIN OUTCOME VARIABLE(S)
The 3D coordinate system error (mm).
COVARIATES
The position of landmarks.
ANALYSES
The Mann-Whitney U test, student's t-test, and the Kruskal-Wallis test were used to analyze the coordinate errors between the landmarks. A P value of < .05 was considered statistically significant.
RESULTS
The 3D error value of the control and experimental group were 1.06 ± 0.63 mm (range: 0.11 to 2.92 mm) and 0.96 ± 0.48 mm (range: 0.2 to 2.95 mm), respectively. There was no statistical difference between the control and experimental group. There was a statistically significant difference in the lower 2 and lower 3 landmarks compared to the upper 1 (P = .001 and .000, respectively) before and after the reduction in the experimental group.
CONCLUSION AND RELEVANCE
This study demonstrates that the reduction using a 3D-printed guide template for the mandibular symphysis fracture could be possible even without the MMF.

Identifiants

DOI: 10.1016/j.joms.2023.05.002 PMID: 37220868
pubmed: 37220868
pii: S0278-2391(23)00399-3
doi: 10.1016/j.joms.2023.05.002
pii:
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

1025-1032

Informations de copyright

Copyright © 2023 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Auteurs

Hee-Yeoung Jung (HY)

Graduate Student, Department of Oral & Maxillofacial Surgery, Chonnam National University Hospital, Gwangju, Republic of Korea; Graduate Student, Department of Oral & Maxillofacial Surgery, School of Dentistry, Dental Science Research Institute, Chonnam National University, Gwangju, Republic of Korea.

Jin-Yong Cho (JY)

Clinical Associate Professor, Department of Oral & Maxillofacial Surgery, Gachon University Gil Medical Center, Incheon, Republic of Korea.

Seunggon Jung (S)

Associate Professor, Department of Oral & Maxillofacial Surgery, Chonnam National University Hospital, Gwangju, Republic of Korea; Associate Professor, Department of Oral & Maxillofacial Surgery, School of Dentistry, Dental Science Research Institute, Chonnam National University, Gwangju, Republic of Korea.

Hong-Ju Park (HJ)

Professor, Department of Oral & Maxillofacial Surgery, Chonnam National University Hospital, Gwangju, Republic of Korea; Professor, Department of Oral & Maxillofacial Surgery, School of Dentistry, Dental Science Research Institute, Chonnam National University, Gwangju, Republic of Korea.

Hee-Kyun Oh (HK)

Professor, Department of Oral & Maxillofacial Surgery, Chonnam National University Hospital, Gwangju, Republic of Korea; Professor, Department of Oral & Maxillofacial Surgery, School of Dentistry, Dental Science Research Institute, Chonnam National University, Gwangju, Republic of Korea.

Jaeyoung Ryu (J)

Associate Professor, Department of Oral & Maxillofacial Surgery, Chonnam National University Hospital, Gwangju, Republic of Korea; Associate Professor, Department of Oral & Maxillofacial Surgery, School of Dentistry, Dental Science Research Institute, Chonnam National University, Gwangju, Republic of Korea. Electronic address: ryu@jnu.ac.kr.

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Classifications MeSH

questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Can Fracture Reduction be Attempted Through a...
questionsmedicales.fr › Sciences de l'information › Affichage de données › Infographie › Conception assistée par ordinateur › Impression tridimensionnelle › Can Fracture Reduction be Attempted Through a...
questionsmedicales.fr › Plaies et blessures › Traumatismes du système nerveux › Traumatismes cranioencéphaliques › Lésions traumatiques de la face › Traumatismes maxillofaciaux › Fractures de la mâchoire › Fractures mandibulaires › Can Fracture Reduction be Attempted Through a...
questionsmedicales.fr › Procédures de chirurgie maxillofaciale et buccodentaire › Techniques de contention de la mâchoire › Can Fracture Reduction be Attempted Through a...
questionsmedicales.fr › Sciences de l'information › Affichage de données › Infographie › Conception assistée par ordinateur › Can Fracture Reduction be Attempted Through a...
questionsmedicales.fr › Procédures de chirurgie opératoire › Procédures orthopédiques › Ostéosynthèse › Can Fracture Reduction be Attempted Through a...