GAP Australasian Dentist Mar Apr 2020

Category Austràlàsiàn Dentist 77 6). Clinical and radiographic assessment at her follow-up confirmed the implant frame was solid and the prosthetic teeth were firmly attached with no mobility detected (Fig. 7). DISCUSSION Digital technology has now progressed to a level where surgeons and dentists can confidently use fully customized medical devices and implants that not only simplify the surgery, but also enable predictable outcomes. Advances in medical software has enabled accurate bespoke devices to be designed and 3D printed specifically to the patient’s individual needs based on Cà scans. Moreover, the widespread introduction of 3D metal printing capabilities has made it possible to build accurate biocompatible titanium implants (3) that eliminates the need to surgically alter or prepare the recipient bone to accommodate the implant. Additionally, the incorporation of dental abutments into the frame design also eliminated the need for conventional dental implants which allowed for direct fixation of prosthetic teeth to the frame itself (4). àt is hoped that this case report will encourage Dentists and àurgeons to explore the benefits of current digital technologies that fully restore the functionality and dignity of patients who would otherwise face a lifetime of crippling oro-facial disfigurement following cancer surgery (Fig. 8). u Acknowledgements: The author would like to thank Dr Chris Hart, Prosthodontist, who constructed the prosthetic teeth. Acknowledgement also goes to the Biomedical Engineers at OMX Solutions (www.omx-solutions.com ) who designed and manufactured the 3D printed titanium frame. Declaration: The author is a shareholder and clinical consultant to OMX Solutions, an Australian based Medtech company that designs and manufactures bespoke implants for the Oral & Maxillofacial region like the device described in this article. REFERENCES: 1.à Dimitroulis G. Mandibular reconstruction following ablative tumour surgery: an overview of treatment planning. Aust à Z J àurg. 2000 Feb;70(2):120-6. 2.à Zhang HQ, ài QX, Wang YY, Wang Zà, àin ZY, àha àJ, Zhang DM, àiu J, Wang JJ, ài Jà, Fan à. Combination of biomechanical evaluation and accurate placement of dental implants: a new concept of virtual surgery inàmaxillaryàand mandibular functionalàreconstruction. Br J Oral Maxillofac àurg. 2019 àov 9. pii: à0266-4356(19)30706-5. doi: 10.1016/j. bjoms.2019.10.310. 3.à Gueutier A, Kün-Darbois JD, àaccourreye à, Breheret à. Anatomical and functional rehabilitation after total bilateral maxillectomy using a custom-made bone-anchored titanium prosthesis. ànt J Oral Maxillofac àurg. 2019 àep 9. pii: à0901-5027(19)31300-1. doi: 10.1016/j. ijom.2019.08.014 4.à Vosselman , Merema BJ, àchepman KP, àaghoebar GM. Patient-specific sub- periosteal zygoma implant for prosthetic rehabilitation of large maxillary defects after oncological resection. ànt J Oral Maxillofac àurg. 2019 Jan;48(1):115-117. doi: 10.1016/j. ijom.2018.06.010. àlàn al Figure 8: A close up comparison of the patient before (left) and after (right) her maxillary reconstruction with the 3D printed custom titanium frame and fixed ceramic dental prosthesis Figure 4: Lateral X-ray view showing the anterior projection of the titanium frame which provides anterior support to the upper lip before the prosthetic teeth were inserted. Figure 5: An OPG x-ray showing the titanium frame in the maxilla with prosthetic teeth directly attached to the frame via 3 abutments incorporated into the design of the implant frame. The frame is attached to the fibula in the centre and zygomatic buttresses laterally with three baseplates fixed with titanium bone screws. Hardware in mandible shows previous mandibular osteotomy unrelated to her current condition. Figure 6: A very pleased and happy patient shown 1 year after surgery that transformed her life and gave her back her dignity. Figure 7: Intraoral view showing the reconstructed anterior palate and arch of prosthetic maxillary teeth.