Major Craniofacial Injury
This patient suffered a major craniofacial injury 30 years ago. Reconstruction of the mandible was carried out using a hip graft, and the chin was reconstructed with a deltopectoral flap.
Severe salivary incontinence prevented a satisfactory quality of life; this was related problems with the hip graft. An SLS biomodel confirmed that the hip graft was :-
Surgery time 1 hour
A precision posterior osteotomy bone cut was planned using a customised cutting jig with a bevelled posterior flange. This permitted accurate angulated bone cuts for removal of a wedge of bone at a precise angle of 8 degrees. Combined with a straight osteotomy bone cut on the anterior flange, this permitted :-
A lower overdenture was constructed at 6 months using the MDI Sendax mini dental implant system http://www.imtec.com
This patient has an excellent outcome with transformation of the quality of life. The denture is absolutely stable and normal eating is now possible.
This case emphasises the role of Engineering Assisted Surgery™ in the conversion of a major surgical problem into a simple surgical solution. A staged reconstruction was possible without the recourse to a major surgical intervention. This has major implications for the purchasers of healthcare. The author argues that the time has now arrived for a major multidisciplinary reappraisal of this technology.
The author wishes to acknowledge the contribution of Peter Pearson of Orthopaedic Innovations, Sheffield whose engineering brilliance made this precision osteotomy possible. The contribution of Dr Victor Sendax, inventor of the MDI Sendax mini implant system was also paramount in achieving the degree of success in this case. The dental laboratory contribution of Mr Ben Swindell of Crown Ceramics Codnor Derbyshire was also invaluable in the manufacture of a superb dental prosthesis.