A CLINICAL CASE OF MANDIBULAR FIBROUS DYSPLASIA TREATMENT USING SURGICAL TEMPLATES AND INDIVIDUALIZED TITANIUM CONSTRUCTION WITH PRELIMINARY VIRTUAL SURGICAL PLANNING

Abstract

Fibrous dysplasia is a pathological condition, the symptoms of which are the occurrence of pathological fractures and bone deformities. The article highlights the advantages of the technique of virtual surgical planning and the prospects of using CAD/CAM technology in the treatment of monoosseous fibrous dysplasia of the mandible. Information technology and additive manufacturing tools allow you to convert digital images obtained from various visualization tools into high-resolution models using CAD/CAM. This technique includes computed tomography, reverse engineering, and rapid prototyping in the production of individual implants for maxillofacial surgery. The design and fabrication process consists of processing medical image data of pathologically altered tissues of the patient’s maxillofacial area with a symmetrical part to build a three-dimensional (3D) digital model, defect side imaging, where different techniques are used for individual cases, including mirroring pathologically unchanged side. Further design of the implant from other CT data of the skull, modeling of the implant geometry, 3D printing of the skull model and resection templates, virtual surgical planning and installation of the prosthesis. As well as 3D printing of individualized titanium plate, pre-modeled on the basis of virtual surgical planning. Individualized solutions are another tool for the doctor that allows you to perform operations with further predictability and reliability. The results of treatment show that the CAD/CAM method allows to improve the reconstruction of defects after surgical resection. 3D printing technology provides precision in preoperative surgical modeling and fabrication of individualized structures for osteosynthesis. Thus, the CAD / CAM method significantly reduced the time of bone graft design and manufacture, achieved clean resection edges, and improved aesthetic and functional postoperative results. The obtained results allow to optimize the surgical treatment of patients with fibrous dysplasia, to introduce into practice the latest technologies that significantly improve the quality of life, medical rehabilitation and social adaptation of patients.

Keywords

• fibrous dysplasia,individualized titanium plate,virtual surgical planning,сad/cam technology.