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Technical Brief

Computer-Aided Design and Manufacturing of a Novel Maxillofacial Surgery Instrument: Application in the Sagittal Split Osteotomy

[+] Author and Article Information
Erol Cansiz

Faculty of Dentistry,
Department of Oral and Maxillofacial Surgery,
Istanbul University,
İstanbul 34104, Turkey;
Ağız-Diş Çene Cerrahisi Anabilim Dalı,
İstanbul Üniversitesi Diş Hekimliği Fakültesi,
Fatih,
İstanbul 34104, Turkey
e-mail: erol.cansiz@istanbul.edu.tr

Fatih Turan

Faculty of Engineering,
Department of Mechanical Engineering,
Istanbul University,
İstanbul 34104, Turkey;
Mühendislik Fakültesi Makine Mühendisliği Bölümü, İstanbul Üniversitesi,
34320, Avcılar,
İstanbul 34104, Turkey
e-mail: fatihturan@istanbul.edu.tr

Yunus Ziya Arslan

Faculty of Engineering,
Department of Mechanical Engineering,
Istanbul University,
İstanbul 34104, Turkey;
Mühendislik Fakültesi Makine Mühendisliği Bölümü,
İstanbul Üniversitesi,
34320, Avcılar,
İstanbul 34104, Turkey
e-mail: yzarslan@istanbul.edu.tr

1Corresponding author.

Manuscript received January 5, 2016; final manuscript received July 2, 2016; published online August 24, 2016. Assoc. Editor: Carl Nelson.

J. Med. Devices 10(4), 044505 (Aug 24, 2016) (4 pages) Paper No: MED-16-1005; doi: 10.1115/1.4034297 History: Received January 05, 2016; Revised July 02, 2016

Mandibular sagittal split osteotomy (SSO) is an operation performed for the correction of mandibular deformities. In this operation, sharp rotary tools are used during osteotomies and this can induce some complications. For example, if the inferior alveolar nerve is damaged, paralysis of the teeth, the lateral side of the tongue, and the corner of the lip can occur. To decrease the occurrence of such possible complications, we designed and manufactured a novel computer-assisted, patient-specific SSO guide and soft tissue retractor in our previous study. And, we first tested this apparatus on a cadaveric bone in vitro. Now, in this study, a surgical application of the instrument, which was designed and manufactured according to the requirements of the mandibular sagittal split osteotomies, was performed. This paper gives and discusses the results obtained from in vivo application of the apparatus.

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References

Wolford, L. M. , Bennett, M. A. , and Rafferty, C. G. , 1987, “ Modification of the Mandibular Ramus Sagittal Split Osteotomy,” Oral Surg., Oral Med., Oral Pathol., 64(2), pp. 146–155. [CrossRef]
Matris, C. S. , 1984, “ Complications After Mandibular Sagittal Split Osteotomy,” J. Oral Maxillofac. Surg., 42(2), pp. 101–107. [CrossRef] [PubMed]
Teerijoki-Oksa, T. , Jääskeläinen, S. , Forssell, K. , Virtanen, A. , and Forssell, H. , 2003, “ An Evaluation of Clinical and Electrophysiologic Tests in Nerve Injury Diagnosis After Mandibular Sagittal Split Osteotomy,” Int. J. Oral Maxillofac. Surg., 32(1), pp. 15–23. [CrossRef] [PubMed]
Van Merkesteyn, J. P. , Groot, R. H. , Van Leeuwaarden, R. , and Kroon, F. H. , 1987, “ Intra-Operative Complications in Sagittal and Vertical Ramus Osteotomies,” Int. J. Oral Maxillofac. Surg., 16(6), pp. 665–670. [CrossRef] [PubMed]
Coghlan, K. M. , and Irvine, G. H. , 1986, “ Neurological Damage After Sagittal Split Osteotomy,” Int. J. Oral Maxillofac. Surg., 15(4), pp. 369–371. [CrossRef] [PubMed]
Kriwalsky, M. S. , Maurer, P. , Veras, R. B. , Eckert, A. W. , and Schubert, J. S. , 2008, “ Risk Factors for a Bad Split During Sagittal Split Osteotomy,” Br. J. Oral Maxillofac. Surg., 46(3), pp. 177–179. [CrossRef] [PubMed]
Obwegeser, H. , 1963, “ The Indications for Surgical Correction of Mandibular Deformity by the Sagittal Splitting Technique,” Br. J. Oral Surg., 1, pp. 157–171. [CrossRef]
Parthasarathy, J. , Starly, B. , and Raman, S. , 2009, “ Computer Aided Biomodeling and Analysis of Patient Specific Porous Titanium Mandibular Implants,” ASME J. Med. Devices, 3(3), p. 031007. [CrossRef]
Cansiz, E. , Arslan, Y. Z. , Turan, F. , and Atalay, B. , 2014, “ Computer-Assisted Design of Patient-Specific Sagittal Split Osteotomy Guide and Soft Tissue Retractor,” J. Med. Biol. Eng., 34(4), pp. 363–367. [CrossRef]
Nicholson, J. W. , 2002, The Chemistry of Medical and Dental Materials, Royal Society of Chemistry, Cambridge, UK.
Khaing, M. W. , Fuh, J. Y. H. , and Lu, L. , 2001, “ Direct Metal Laser Sintering for Rapid Tooling: Processing and Characterisation of EOS Parts,” J. Mater. Process. Technol., 113(1–3), pp. 269–272. [CrossRef]
Trauner, R. , and Obwegeser, H. , 1957, “ The Surgical Correction of Mandibular Prognathism and Retrognathia With Consideration of Genioplasty: Part I. Surgical Procedures to Correct Mandibular Prognathism and Reshaping of the Chin,” Oral Surg., Oral Med., Oral Pathol., 10(7), pp. 667–689. [CrossRef]
Al-Bishri, A. , Barghash, Z. , Rosenquist, J. , and Sunzel, B. , 2005, “ Neurosensory Disturbance After Sagittal Split and Intraoral Vertical Ramus Osteotomy: As Reported in Questionnaires and Patients' Records,” Int. J. Oral Maxillofac. Surg., 34(3), pp. 247–251. [CrossRef] [PubMed]
Santos, E. C. , Shiomi, M. , Osakada, K. , and Laoui, T. , 2006, “ Rapid Manufacturing of Metal Components by Laser Forming,” Int. J. Mach. Tools Manuf., 46(12–13), pp. 1459–1468. [CrossRef]

Figures

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Fig. 1

Sagittal split osteotomy line specified onto the three-dimensional model of the patient's mandible

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Fig. 2

The designed sagittal split osteotomy guide and soft tissue retractor

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Fig. 3

Different views of the instrument placed on the mandible

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Fig. 4

Detailed views of the retractors designed to protect the inferior neurovascular bundle

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Fig. 5

Manufactured instrument by laser sintering technology

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Fig. 6

Application of the instrument during the sagittal split osteotomy

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Fig. 7

Different views of the sagittal split osteotomy performed using the novel instrument. Rotary instrument follow the osteotomy line guided by the proposed device.

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