Abstract
Gunshot wounds of the lower face are a challenge for the surgeon. Customized distraction
osteogenesis (DO) is a well-established procedure for managing facial gunshot wounds.
However, differences between the preoperative planning and postoperative outcomes
are often noted. This multi-centre, retrospective study was performed to analyse the
differences between the planning and outcomes for the lower third of the face, in
patients undergoing the computer-assisted repair of mandible gunshot wounds using
patient-specific distraction devices. Different planes and points were defined, and
two distances (anteroposterior and intercondylar lengths) and an angle (inter-mandible
body angle) were measured on the preoperative planning models and the postoperative
models obtained from the computed tomography data. Twelve patient cases that met the
study eligibility criteria were included. A significant difference between the planning
and postoperative outcome was found for the anteroposterior length (6.6 mm shorter
than the preoperative planning; P = 0.003). The differences in intercondylar length (P = 0.116) and inter-mandible body angle (P = 0.121) were not significant. This study revealed a difference between the planning
and outcomes. Various factors such as scar tissue and muscle forces limit distraction
and therefore lead to under-correction with insufficient projection.
Keywords
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References
- Mandibular traumas by gunshot. A systematic review with meta-analysis and algorithm of treatment.Br J Oral Maxillofac Surg. 2021; 59: e99-e108
- Distraction osteogenesis versus fibula free flap for mandibular reconstruction after gunshot injury: socioeconomic and technical comparisons.J Craniofac Surg. 2011; 22: 876-882
- Use of virtual 3-dimensional surgery in post-traumatic craniomaxillofacial reconstruction.J Oral Maxillofac Surg. 2011; 69: 733-741
- Accuracy of fibula reconstruction using patient-specific CAD/CAM reconstruction plates and dental implants: a new modality for functional reconstruction of mandibular defects.J Craniomaxillofac Surg. 2015; 43: 649-657
- Three-dimensional virtual surgery accuracy for free fibula mandibular reconstruction: planned versus actual results.J Oral Maxillofac Surg. 2014; 72: 2601-2612
- Optimization of curvilinear mandible distraction using 3-dimensional computer-simulated modelling.J Craniofac Surg. 2012; 23: 1713-1716
- Evaluation of virtual surgical planning systems and customized devices in fibula free flap mandibular reconstruction.Eur Arch Otorhinolaryngol. 2019; 276: 3477-3486
- Mandibular reconstruction using computer-aided design and computer-aided manufacturing: an analysis of surgical results.J Oral Maxillofac Surg. 2013; 71: e111-e119
- Computer planning for distraction osteogenesis.Plast Reconstr Surg. 2000; 105: 873-882
- Implant insertion in distracted bone for reconstruction after gunshot injury.Rev Stomatol Chir Maxillofac. 2012; 113: 239-244
- Accuracy of a CAD/CAM surgical template for mandibular distraction: a preliminary study.Br J Oral Maxillofac Surg. 2018; 56: 814-819
- Accuracy of virtually planned mandibular distraction in a pediatric case series.J Craniomaxillofac Surg. 2021; 49: 154-165
- Gunshot wounds: reconstruction of the lower face by osteogenic distraction.Plast Reconstr Surg. 2005; 116: 1596-1603
- Distraction osteogenesis of the mandible: a ten-year experience.Semin Orthod. 1999; 5: 3-8
- Biomechanical considerations of mandibular lengthening and widening by gradual distraction using a computer model.J Oral Maxillofac Surg. 1998; 56: 51-59
- Mandibular distraction force: laboratory data and clinical correlation.J Oral Maxillofac Surg. 2001; 59: 539-544
Article info
Publication history
Published online: January 23, 2023
Accepted:
January 16,
2023
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2023 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.
