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Reconstruction of skull defects with computer manufactured models
P21-4 Reconstructive surgery & Temporomandibular joint 8. Reconstruction of the Lateral Wall of the Pharynx after Ablative Surgery
10, Reconstruction of Skull Defects with Computer Manufactured Models
Lung, T., Muresan, O.
Bill, J. S., Reuther, J. E, Kueblev, N. R., Pistner, H., Betz, T., Wittenberg, G., Keliner, M.
Clinic for Oral and Maxillofacial Surgery, University of Medicine and Pharmacy, Cluj-Napoca, Romania Eleven patients with tumors extending to the lateral pharyngeal wall were treated. The lateral pharyngeal wall was reconstructed using a forehead flap in 7 patients and a palatal flap pedicled to the greater palatine artery, in 4 patients. The remaining defects were covered with pectoral flaps or pectoralis major flaps. All flaps healed well and patients had no functional problem with regard to speech and swallowing.
9. Three Dimensional Analysis and Interactive Manipulation of CT-Scans for Flap Prefabrication and Plastic Reconstructive Surgery of Craniomaxillofacial Deformities
Preissl, jj,3, Vinzenz K. G.l'2,3, Holle, j.2, Kulenkampff K.-J.4 1Department for MaxillofaciaI Surgery, Evangelisches Krankenhaus Wien- Wgihring, 2Department for Plastic and Reconstructive Surgery, Wilhelminenspital, 3ResearehInstitute Jbr Reconstructive OMF-Surgery and Tissueintegrated Prosthesis, 4Department for Radiology, Krankenhaus Lainz, Vienna, Austria Supplementary to imaging systems like computer tomography (CT) and magnetic resonance imaging (MRI) that show cross-sectional images of a patient a number of twodimensional (2D) and three-dimensional (3D) visualizing and manipulation systems have been developed or are in the process of development, e.g. 3D Viewnix, Analyse, Osiris, A R R I Voxel Flinger. Furthermore 3D-modelling technology is a necessary tool for operation planning like stereolithographic models (Laserform | Vienna). An open system design offers the best possibility to easily integrate newly developed tools for various operational tasks in the maxillofacial region: e.g. preoperative simulation of reconstructive surgery, cephalometric planning of orthodontic surgery, navigation systems for tumor surgery, osteosynthesis and/or implantology. With the data provided by the imaging systems it is possible to perform (new) surgical treatment by 3D-cephalometric investigations. Another goal is to improve the flap design of the transplants for complex microsurgical reconstruction by a precise correlation between the donor site and the maxillofacial defects, resulting in 3D-computer-aided tissue preparation i.e. "prefabricated flaps". Tasks like these require detailed planning and simulation of operations. The systems must support standard file formats of A C R - N E M A and DICOM. The developments must be undertaken in close cooperation with the user.
167
Department of Cranio-Maxillo-Facial Surgery, Medical School, University of Wuerzburg, Wuerzburg, Germany Loss of large parts of the neurocranium due to trauma, tumor or infections makes necessary an adequate reconstruction since the brain covered only by the scalp is in danger of trauma or infection. Methods of reconstruction used until now were not sufficient to reshape the surface of the skull causing asymmetries and bad functional and aesthetic results. Intraoperatively shaped acrylic reconstructions frequently caused infections and dehiscences with necessary reoperations. Computer assisted manufacturing of organ models, before all stereolithography, made possible accurate preoperative planning of skull reconstruction. The advantage of this model manufacturing technique compared to others is their intraoperative usability. Mirror imaging of contralateral parts of the skull onto defect regions in cases with mirrorable defects was first used in our hospital, as well as superposition of defects with CTdatabase skull datasets in cases with non-mirrorable defects respectively with model manufacturing opened up new ways in planning of skull defect reconstruction with optimized three dimensional shape of the reconstruction. By use of such a computer manufactured reconstruction model and calvarial bone from a bone bank an accurate bony reconstruction of skull defects can be planned preoperative for upcoming insertion and fixation of the prepared bone transplant into the defect. From 1993 until 1997 an overall of 24 patients with large skull defects have been treated by the described method with excellent postoperative functional, aesthetic and symmetrical results becoming method of choice for these indications. Further indications for the use of medical models for surgery planning in our hospital are large skeletal defects after tumor or trauma, craniofacial deformities and dental implantology planning.
11. Experimental Study on All Dimple System Implants
Azuma, B. 1, Takahashi, yl, Hasegawa, j.l, Tanaka, H. 2, Maeda, H. 2, Kameyama, yz 1Department of Dent. Mater. Sci., 2Department of Pathol., Sch. of Dent., Aichi-Gakuin Univ., Nagoya, Japan We have developed a new all dimple system (ADS) intraosseous dental implant. It is made of pure titanium and has small and large dimples on its surface. One male dog, about 10 years old, and weighing 13.5 kilograms, was used as an experimental animal. The right mandibular third and fourth premolar teeth were extracted under anesthesia. A fixture
10, Reconstruction of Skull Defects with Computer Manufactured Models
Lung, T., Muresan, O.
Bill, J. S., Reuther, J. E, Kueblev, N. R., Pistner, H., Betz, T., Wittenberg, G., Keliner, M.
Clinic for Oral and Maxillofacial Surgery, University of Medicine and Pharmacy, Cluj-Napoca, Romania Eleven patients with tumors extending to the lateral pharyngeal wall were treated. The lateral pharyngeal wall was reconstructed using a forehead flap in 7 patients and a palatal flap pedicled to the greater palatine artery, in 4 patients. The remaining defects were covered with pectoral flaps or pectoralis major flaps. All flaps healed well and patients had no functional problem with regard to speech and swallowing.
9. Three Dimensional Analysis and Interactive Manipulation of CT-Scans for Flap Prefabrication and Plastic Reconstructive Surgery of Craniomaxillofacial Deformities
Preissl, jj,3, Vinzenz K. G.l'2,3, Holle, j.2, Kulenkampff K.-J.4 1Department for MaxillofaciaI Surgery, Evangelisches Krankenhaus Wien- Wgihring, 2Department for Plastic and Reconstructive Surgery, Wilhelminenspital, 3ResearehInstitute Jbr Reconstructive OMF-Surgery and Tissueintegrated Prosthesis, 4Department for Radiology, Krankenhaus Lainz, Vienna, Austria Supplementary to imaging systems like computer tomography (CT) and magnetic resonance imaging (MRI) that show cross-sectional images of a patient a number of twodimensional (2D) and three-dimensional (3D) visualizing and manipulation systems have been developed or are in the process of development, e.g. 3D Viewnix, Analyse, Osiris, A R R I Voxel Flinger. Furthermore 3D-modelling technology is a necessary tool for operation planning like stereolithographic models (Laserform | Vienna). An open system design offers the best possibility to easily integrate newly developed tools for various operational tasks in the maxillofacial region: e.g. preoperative simulation of reconstructive surgery, cephalometric planning of orthodontic surgery, navigation systems for tumor surgery, osteosynthesis and/or implantology. With the data provided by the imaging systems it is possible to perform (new) surgical treatment by 3D-cephalometric investigations. Another goal is to improve the flap design of the transplants for complex microsurgical reconstruction by a precise correlation between the donor site and the maxillofacial defects, resulting in 3D-computer-aided tissue preparation i.e. "prefabricated flaps". Tasks like these require detailed planning and simulation of operations. The systems must support standard file formats of A C R - N E M A and DICOM. The developments must be undertaken in close cooperation with the user.
167
Department of Cranio-Maxillo-Facial Surgery, Medical School, University of Wuerzburg, Wuerzburg, Germany Loss of large parts of the neurocranium due to trauma, tumor or infections makes necessary an adequate reconstruction since the brain covered only by the scalp is in danger of trauma or infection. Methods of reconstruction used until now were not sufficient to reshape the surface of the skull causing asymmetries and bad functional and aesthetic results. Intraoperatively shaped acrylic reconstructions frequently caused infections and dehiscences with necessary reoperations. Computer assisted manufacturing of organ models, before all stereolithography, made possible accurate preoperative planning of skull reconstruction. The advantage of this model manufacturing technique compared to others is their intraoperative usability. Mirror imaging of contralateral parts of the skull onto defect regions in cases with mirrorable defects was first used in our hospital, as well as superposition of defects with CTdatabase skull datasets in cases with non-mirrorable defects respectively with model manufacturing opened up new ways in planning of skull defect reconstruction with optimized three dimensional shape of the reconstruction. By use of such a computer manufactured reconstruction model and calvarial bone from a bone bank an accurate bony reconstruction of skull defects can be planned preoperative for upcoming insertion and fixation of the prepared bone transplant into the defect. From 1993 until 1997 an overall of 24 patients with large skull defects have been treated by the described method with excellent postoperative functional, aesthetic and symmetrical results becoming method of choice for these indications. Further indications for the use of medical models for surgery planning in our hospital are large skeletal defects after tumor or trauma, craniofacial deformities and dental implantology planning.
11. Experimental Study on All Dimple System Implants
Azuma, B. 1, Takahashi, yl, Hasegawa, j.l, Tanaka, H. 2, Maeda, H. 2, Kameyama, yz 1Department of Dent. Mater. Sci., 2Department of Pathol., Sch. of Dent., Aichi-Gakuin Univ., Nagoya, Japan We have developed a new all dimple system (ADS) intraosseous dental implant. It is made of pure titanium and has small and large dimples on its surface. One male dog, about 10 years old, and weighing 13.5 kilograms, was used as an experimental animal. The right mandibular third and fourth premolar teeth were extracted under anesthesia. A fixture