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Fracture of Standard Titanium Mandibular Reconstruction Plates and Preliminary Study of Three-Dimensional Printed Reconstruction Plates

Cited 19 time in Web of Science Cited 23 time in Scopus
Authors

Almansoori, Akram Abdo; Choung, Han-Wool; Kim, Bongju; Park, Joo-Young; Kim, Soung-Min; Lee, Jong-Ho

Issue Date
2020-01
Publisher
W. B. Saunders Co., Ltd.
Citation
Journal of Oral and Maxillofacial Surgery, Vol.78 No.1, pp.153-166
Abstract
Purpose: A cohort review was performed to compare the effect of a number of variables on mandible reconstruction plate (R-plate) survival and to identify the potential risk factors for plate fracture. We also reported our preliminary results of 3-dimensional (3D) printed reconstruction plates. Patients and Methods: The data from patients who had undergone mandibular reconstruction using reconstruction plates were evaluated for age, gender, mandibular resection indication, defect site and length, remaining occluded teeth, reconstruction plate type, simultaneous soft or bone tissue reconstruction, and radiotherapy. The plate survival rate was estimated using the Kaplan-Meier curve, and the variables were compared using the log-rank (Mantel-Cox) test. Multifactorial risk correlation was determined using logistic regression analysis. Results: The study included 159 patients who had been followed for 97 +/- 5.4 months. Of the 159 patients, 22 had experienced plate fracture that had occurred within 20 months. Most of the plate fractures had occurred near the mandibular bone stump, passing through the shoulder of the plate hole or the bridge between the subsequent plate holes. The overall survival was 86.2%. Patients with few occluded teeth (type I) had a significantly greater R-plate survival rate compared with those with many occluded teeth (P = .045). Laterocentral "LC'' defects had a significantly lower survival rate (44.4%) compared with lateral "L'' defects (84.5%; P = .00). The survival rates with soft tissue (88.7%) or bone tissue reconstruction (100%) were significantly different compared with that for R-plate alone (40%; P = .000 and P = .004, respectively). Four patients received 3D printed R-plates and were followed for 2 to 8 months (mean, 4 months) with no complications. Conclusions: Patients with many remaining occluded teeth, LC defect, and the absence of simultaneous soft or bone tissue reconstruction were associated with a lower plate survival rate. Bending of the plate increased the incidence of plate fracture, and the use of 3D printed customized R-plates seems a valuable alternative.
ISSN
0278-2391
URI
https://hdl.handle.net/10371/202746
DOI
https://doi.org/10.1016/j.joms.2019.07.016
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  • School of Dentistry
  • Department of Dentistry
Research Area 구강 및 턱뼈 (구강악안면) 의 면역 항상성 유지기전에 대한 연구

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