Maxilla Reconstruction Using Customized 3D Printed Plate
Virtual planning and 3D printing PSI for Maxilla reconstruction with fibula free flap
Sheba Medical Center.
Upper jaw - maxilla reconstructions are usually more complex than lower jaw – mandibula – reconstructions and require great precision.
For maximum precision in maxilla surgery, at Sheba Hospital, they performed computerized 3D design and used patient specific instruments to guide the surgery and in addition, a customized 3D printed plate 3D printed of titanium.
At the start of surgery, the part of the maxilla affected by the tumor is resected. After resection, the jaw is reconstructed with segments of the fibula bone and soft tissue with blood vessels are transferred to the area of the jaw.
In order to perform the maxilla resection and reconstruction most accurately, surgery is planned using 3D visualization and performed using patient specific instruments manufactured using 3D printing from biocompatible materials with sterilization capabilities.
In order to reconstruct the maxilla most accurately, a specific patient instrument was designed. The plate was designed to fix fibula bone segments as precisely as possible based on computerized designs.
Computerized designs of the plate allow designing the plate with fixation to the zygoma and maxilla. With this method, stabilization is much more effective than when using off-the-shelf plates. In addition, the location of screws can be predesigned in order not to interfere with dental implants in the future.
The patient specific instrument for cutting the fibula was designed with drilling guides to perfectly line up with screw holes in the printed plate, as was the maxilla cutting guide. Computerized designs were executed near perfectly and the patient specific plate precisely matched patient anatomy for the reconstruction.
For further reading on computerized planning in mandibular reconstruction: Mandibular Reconstruction with Fibula Free Flap Surgery.
Patient specific plates can be printed in titanium for different anatomies.