Use of a titanium cutting guide to assist with raising and inset of a DCIA free flap

Abstract Reconstructing maxillary defects can be challenging. In particular, Class 3 and 4 defects require careful planning. Bone for reconstruction must be placed in the correct three dimensional (3D) position in order to achieve a good cosmetic and functional result. Correct size and positioning o...

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Bibliographic Details
Published in:British journal of oral & maxillofacial surgery 2013-12, Vol.51 (8), p.958-961
Main Authors: Thomas, Cellan V, McMillan, Kevin G, Jeynes, Pete, Martin, Tim, Parmar, Sat
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Biocompatible Materials - chemistry
Bone Plates
Bone Transplantation - instrumentation
Computer-Aided Design
Cutting guides
DCIA free flap
Dentistry
Equipment Design
Esthetics
Female
Free Tissue Flaps - transplantation
Humans
Ilium - diagnostic imaging
Ilium - surgery
Imaging, Three-Dimensional - methods
Male
Maxilla - diagnostic imaging
Maxilla - surgery
Maxillary Neoplasms - surgery
Maxillary reconstruction
Middle Aged
Operative Time
Patient Care Planning
Printing, Three-Dimensional
Reconstructive Surgical Procedures - instrumentation
Stereolithographic models
Surgery
Tissue and Organ Harvesting - instrumentation
Titanium - chemistry
Tomography, X-Ray Computed - methods
Transplant Donor Site - diagnostic imaging
Transplant Donor Site - surgery
Treatment Outcome
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Description
Summary:Abstract Reconstructing maxillary defects can be challenging. In particular, Class 3 and 4 defects require careful planning. Bone for reconstruction must be placed in the correct three dimensional (3D) position in order to achieve a good cosmetic and functional result. Correct size and positioning of the harvested bone also enables placement of dental implants and allows rehabilitation. We describe the use of a Deep Circumflex Iliac Artery Flap (DCIA) cutting guide to aid safe harvest and positioning of the correct quality and quantity of bone. We illustrate the benefits of using a guide based upon stereolithographic planning models of the pelvis by presenting 4 cases where planning to this level has been used. Our experiences clearly demonstrate the potential benefits that preformed cutting guides may have on outcomes when reconstructing complex maxillary defects. In particular, we note a reduction in operative time and improved functional and aesthetic results. The use of such a guide has not previously been described.
ISSN:0266-4356
1532-1940
DOI:10.1016/j.bjoms.2013.04.014