Evaluation of 3D visualization, planning and printing techniques in alveolar cleft repair, and their effect on patients' burden - 29/10/21

Doi : 10.1016/j.jormas.2021.10.007

Artúr Kesztyűs ^⁎^a,^{^{⁎
The first two authors contributed equally to the preparation of this manuscript, both in the clinical and scientific activities. Thus here we declare a shared first authorship for Dr. Kesztyűs and Dr. Würsching.}} , Tamás Würsching ^⁎^b,^{^{⁎
The first two authors contributed equally to the preparation of this manuscript, both in the clinical and scientific activities. Thus here we declare a shared first authorship for Dr. Kesztyűs and Dr. Würsching.}} , Bálint Nemes ^c, Laura Pálvölgyi ^d, Krisztián Nagy ^a,^b,^e,^⁎
^a The Cleft Centre, 1st Department of Pediatrics, Semmelweis University Budapest, Hungary, OMFS-IMPATH Research Group, Faculty of Medicine, Department of Imaging and Pathology, KU Leuven and Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
^b The Cleft Centre, 1st Department of Pediatrics, Semmelweis University Budapest, Hungary, Department of Oro-Maxillofacial Surgery and Stomatology, Semmelweis University Budapest, Hungary
^c Department of Paediatric Dentistry and Orthodontics, Semmelweis University Faculty of Dentistry, Budapest, Hungary
^d The Cleft Centre, 1st Department of Pediatrics, Semmelweis University Budapest, Hungary
^e The Cleft Centre, 1st Department of Pediatrics, Semmelweis University Budapest, Hungary; OMFS-IMPATH Research Group, Faculty of Medicine, Department of Imaging and Pathology, KU Leuven and Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium, Cleft and Craniofacial Centre, Division of Maxillo-Facial Surgery, General Hospital St. Jan, Bruges, Belgium

^⁎Corresponding authors at: 1st Department of Paediatrics, Bókay J. u. 53-54, 1083 Budapest, Hungary.1st Department of PaediatricsBókay J. u. 53-54Budapest1083Hungary

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Abstract

Backgrounds

The aim of this study was to describe our auxiliary surgical techniques in alveolar cleft reconstruction and evaluate the patients burden after 3 years of surgical experience.

Methods

At the Cleft center, Semmelweis University Budapest, 28 patients underwent alveolar bone grafting between September 2017 and September 2020. We have used CBCT scans and computer software to perform 3D simulation of the alveolar defect and planning of patient- and defect specific grafts. An individual graft mold was designed for each alveolar defect and 3D printed for intra-operative use. During the surgical intervention, the mold was used to harvest the most appropriate amount and precise shape of graft material. We used cancellous iliac crest graft. After performing a descriptive statistical analysis of our patient group, we used a quality-of-life questionnaire to measure the patient's self-perception.

Results

In all cases the treatment sequence could be applied, planning and surgery was successful and uneventful. Patients did not experience more pain, bleeding or any feeding impairment. No inflammatory or wound healing reactions were observed. There were no major adverse effects causing permanent problems.

Conclusions

Our follow-up and patient satisfaction questionnaire showed that our treatment sequence with auxiliary techniques brought no further burden to the patients care and hospitalization, even though it is more complex. Efficacy of this treatment method and improvement in graft integration has yet to be determined.

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Keywords : SABG, 3D surgical planning, Alveolar cleft reconstruction