Revista de otología y rinología

Virtual Planning and Application of Computer-aided Designed/ Computer-aided Manufactured Technique for Reconstruction of Mandible Defects with Iliac Crest Flaps

Jan Rustemeyer, Alexander Busch, Alex Melenberg and Aynur Sari-Rieger

Virtual Planning and Application of Computer-aided Designed/ Computer-aided Manufactured Technique for Reconstruction of Mandible Defects with Iliac Crest Flaps

Background: Over the past years, the application of computeraided designed/ computer-aided manufactured (CAD/CAM) technique for reconstruction of defects of the facial skeleton has moved into the focus of reconstructive surgery. We report herein our considerations and experiences using CAD/CAM technique in the reconstruction of mandibular defects with free non-vascularized and vascularized iliac crest bone flaps.

Case report: Three cases are presented in which subjects received an osseous reconstruction using CAD/CAM technique. In the first case, a free iliac crest transplant was used for reconstruction of a mandibular defect consisting essentially of the alveolar ridge. In the second case, a vascularized iliac bone transplant was performed to reconstruct the mandibular ramus and angle. The third case comprised the reconstruction of a wide mandibular defect using a vascularized three-segment iliac crest flap. Our experiences in the presented cases were especially that the CAD/CAM technique facilitated finding and harvesting bone segments that closely duplicated the shape of the natural mandible. Hence, accuracy was high and further trimming and blurring of the osseous transplant was not necessary.

Conclusion: Our experiences fulfilled the challenge to improve traditional shaping methods. At the current state of the art, we believe that the application of CAD/CAM techniques is helpful to restore both complex and less complex mandible defects.