3D virtual surgical planning in patients with bilateral cleft lip and palate undergoing premaxilla osteotomy combined with secondary alveolar bone grafting: a retrospective accuracy analysis.

This retrospective study evaluates the surgical accuracy of 3D virtual planning and the use of computer-aided design/computer-aided manufacturing splints in premaxillary osteotomy combined with secondary alveolar bone grafting. The study included all consecutive patients with bilateral cleft lip and palate undergoing a premaxillary osteotomy with secondary alveolar bone grafting treated by the Cleft Team North (the Netherlands) between 2016 and 2023. 3D virtual surgical planning was based on cone beam computed tomography scans and intraoral scans or plaster models.

Automatic MRI segmentation of masticatory muscles using deep learning enables large-scale muscle parameter analysis.

Mandibular reconstruction to restore mandibular continuity often relies on patient-specific implants and virtual surgical planning, but current implant designs rarely consider individual biomechanical demands, which are critical for preventing complications such as stress shielding, screw loosening, and implant failure. The inclusion of patient-specific masticatory muscle parameters such as cross-sectional area, vectors, and volume could improve implant success, but manual segmentation of these parameters is time-consuming, limiting large-scale analyses. In this study, a deep learning model was trained for automatic segmentation of eight masticatory muscles on MRI images.

Mandibular Implants: A Metamaterial-Based Approach to Reducing Stress Shielding.

Biomechanical complications, such as stress shielding, bone resorption, and reconstruction failure, are prevalently associated with solid titanium mandible reconstruction plates. This study evaluates the potential of metamaterial designs with porous gyroid microarchitectures, to enhance biomechanical stimulation and mitigate these complications. A novel metamaterial reconstruction plate is compared with solid titanium plates, both patient-specifically designed and fabricated from Ti6Al4 V alloy.

A non-metallic PEEK topology optimization reconstruction implant for large mandibular continuity defects, validated using the MANDYBILATOR apparatus.

In cases of large mandibular continuity defects resulting from malignancy resection, the current standard of care involves using patient-specific/custom titanium reconstruction plates along with autogenous grafts (fibula, scapula, or iliac crest segments). However, when grafts are not feasible or desired, only the reconstruction plate is used to bridge the gap. Unfortunately, metal osteosynthesis and reconstruction plates, including titanium, exhibit adverse effects such as stress-shielding and limitations in accurate postoperative irradiation (especially with proton-beam therapy).

Patient satisfaction after conservative treatment of anterior wall frontal sinus fractures.

This study aims to determine patient forehead aesthetics satisfaction after conservative treatment of non-dislocated and dislocated anterior wall frontal sinus fractures. Prospectively, patients older than 15 years of age with a frontal sinus fracture, treated conservatively between the period of 2010-2020, were analysed. The Face-Q questionnaire was used to assess patient satisfaction, and the fracture dimensional properties were measured using computed tomography.