Accuracy of fibula reconstruction using patient-specific CAD/CAM reconstruction plates and dental implants: A new modality for functional reconstruction of mandibular defects

2015 ◽  
Vol 43 (5) ◽  
pp. 649-657 ◽  
Author(s):  
Rutger H. Schepers ◽  
Gerry M. Raghoebar ◽  
Arjan Vissink ◽  
Martin W. Stenekes ◽  
Joep Kraeima ◽  
...  
Keyword(s):  
Dental Implants ◽  
Patient Specific ◽  
Functional Reconstruction ◽  
Cad Cam

scholarly journals On the effect of antiresorptive drugs on the bone remodeling of the mandible after dental implantation: a mathematical model

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Mehran Ashrafi ◽  
Farzan Ghalichi ◽  
Behnam Mirzakouchaki ◽  
Manuel Doblare
Keyword(s):  
Mathematical Model ◽  
Bone Density ◽  
Bone Remodeling ◽  
Dental Implants ◽  
Implant Design ◽  
Patient Specific ◽  
Dental Implantation ◽  
Antiresorptive Agents ◽  
Antiresorptive Drugs

AbstractBone remodeling identifies the process of permanent bone change with new bone formation and old bone resorption. Understanding this process is essential in many applications, such as optimizing the treatment of diseases like osteoporosis, maintaining bone density in long-term periods of disuse, or assessing the long-term evolution of the bone surrounding prostheses after implantation. A particular case of study is the bone remodeling process after dental implantation. Despite the overall success of this type of implants, the increasing life expectancy in developed countries has boosted the demand for dental implants in patients with osteoporosis. Although several studies demonstrate a high success rate of dental implants in osteoporotic patients, it is also known that the healing time and the failure rate increase, necessitating the adoption of pharmacological measures to improve bone quality in those patients. However, the general efficacy of these antiresorptive drugs for osteoporotic patients is still controversial, requiring more experimental and clinical studies. In this work, we investigate the effect of different doses of several drugs, used nowadays in osteoporotic patients, on the evolution of bone density after dental implantation. With this aim, we use a pharmacokinetic–pharmacodynamic (PK/PD) mathematical model that includes the effect of antiresorptive drugs on the RANK/RANK-L/OPG pathway, as well as the mechano-chemical coupling with external mechanical loads. This mechano-PK/PD model is then used to analyze the evolution of bone in normal and osteoporotic mandibles after dental implantation with different drug dosages. We show that using antiresorptive agents such as bisphosphonates or denosumab increases bone density and the associated mechanical properties, but at the same time, it also increases bone brittleness. We conclude that, despite the many limitations of these very complex models, the one presented here is capable of predicting qualitatively the evolution of some of the main biological and chemical variables associated with the process of bone remodeling in patients receiving drugs for osteoporosis, so it could be used to optimize dental implant design and coating for osteoporotic patients, as well as the drug dosage protocol for patient-specific treatments.

Biomechanical In Vitro Study on the Stability of Patient-Specific CAD/CAM Mandibular Reconstruction Plates: A Comparison Between Selective Laser Melted, Milled, and Hand-Bent Plates

2020 ◽  
pp. 194338752095268
Author(s):  
Robin Kasper ◽  
Karsten Winter ◽  
Sebastian Pietzka ◽  
Alexander Schramm ◽  
Frank Wilde
Keyword(s):  
In Vitro Study ◽  
Mandibular Reconstruction ◽  
Patient Specific ◽  
Plate Fracture ◽  
Computer Aided ◽  
Cad Cam ◽  
Number Of Cycles ◽  
Bent Plates ◽  
Cam Systems

Study Design: An experimental in vitro study. Objective: Plate fractures are a recurrent problem in alloplastic mandibular reconstruction. Hypothetically it can be assumed that computer-aided design (CAD)/computer-aided manufacturing (CAM) reconstruction plates have a higher stability than conventional hand-bent plates. The aim of the study was to compare additive and subtractive fabricated CAD/CAM mandibular reconstruction plates as well as conventional plates with regard to their biomechanical properties. Methods: In a chewing simulator, plates of 2 conventional locking plate systems and 2 CAD/CAM-fabricated plate systems were compared. The plates were loaded in a fatigue test. The maximum number of cycles until plate fracture and the plate stiffness were compared. Results: While all conventional plates fractured at a maximum load between 150 and 210 N (Newton) after a number of cycles between 40 000 and 643 000, none of the CAD/CAM plates broke despite a nearly doubled load of 330 N and 2 million cycles. Both CAD/CAM systems proved to be significantly superior to the hand-bent plates. There was no difference between the 2 CAD/CAM systems. Conclusions: Concerning the risk of plate fracture, patient-specific CAD/CAM reconstruction plates appear to have a significant advantage over conventional hand-bent plates in alloplastic mandibular reconstruction.

scholarly journals Single-Step Resection of Sphenoorbital Meningiomas and Orbital Reconstruction Using Customized CAD/CAM Implants

2019 ◽  
Vol 81 (02) ◽  
pp. 142-148
Author(s):  
Lukas Goertz ◽  
Pantelis Stavrinou ◽  
George Stranjalis ◽  
Marco Timmer ◽  
Roland Goldbrunner ◽  
...  
Keyword(s):  
Computer Aided Design ◽  
Tumor Resection ◽  
Single Step ◽  
Ct Scans ◽  
Patient Specific ◽  
Orbital Decompression ◽  
Bone Resection ◽  
Orbital Reconstruction ◽  
Orbital Wall ◽  
Cad Cam

Abstract Objective Computer-aided design and manufacturing (CAD/CAM) implants are fabricated based on volumetric analysis of computed tomography (CT) scans and are routinely used for the reconstruction of orbital fractures. We present three cases of patients with sphenoorbital meningiomas that underwent tumor resection, orbital decompression, and orbital reconstruction with patient specific porous titanium or acrylic implants in a single procedure. Methods The extent of bone resection of the sphenoorbital meningiomas was planned in a virtual three-dimensional (3D) environment using preoperative thin-layer CT data. The anatomy of the orbital wall in the resection area was reconstructed by superimposing the contralateral unaffected orbit and by using the information of the neighboring bony structures. The customized implants and a corresponding craniotomy template were designed in the desired size and shape by the manufacturer. Results All patients presented with a sphenoorbital meningioma and exophthalmos. After osteoclastic craniotomy with the drilling template, orbital decompression was performed. Implant fitting was tight in two cases and could be easily fixated with miniplates and screws. In the third patient, a reoperation was necessary for additional bone resection, as well as drilling and repositioning of the implant. The postoperative CT scans showed an accurate reconstruction of the orbital wall. After surgery, exophthalmos was substantially reduced and a satisfying cosmetic result could be finally achieved in all patients. Conclusions The concept of preoperative 3D virtual treatment planning and single-step orbital reconstruction with CAD/CAM implants after tumor resection involving the orbit is well feasible and can lead to good cosmetic results.

Immediate CAD/ CAM Custom Fabricated Dental Implants

2010 ◽  
Vol 1 (2) ◽  
pp. 94-98
Author(s):  
Jafar Kolahi
Keyword(s):  
Dental Implants ◽  
Cad Cam
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