Publications by authors named "Rutger Schepers"

: Patient-specific osteosynthesis (PSO) plates, in combination with virtual surgical planning (VSP), have significantly improved the accuracy of orthognathic surgery. This study aimed to compare the surgical accuracy of two-plate versus four-plate fixation methods in Le Fort I osteotomies using PSO. : A retrospective cohort study was conducted on 21 patients who underwent maxilla-first bimaxillary surgery at a single centre in 2024.

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To accelerate cutaneous wound healing and prevent scarring, regenerative approaches such as injecting a mechanically derived tissue stromal vascular fraction (tSVF) are currently under clinical and laboratory investigations. The aim of our study was to investigate a platform to assess the interaction between skin-derived extracellular matrix (ECM) hydrogels and tSVF and their effects on their microenvironment in the first ten days of culture. A tSVF mixed with ECM hydrogel was cultured for ten days.

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The face is the initial feature used to judge gender in public spaces; it is also a source of significant gender dysphoria. Surgical techniques are available for non-cisgender male patients who desire a more masculine face by augmenting certain features to change the bony framework of the skull. Augmentation using virtually designed patient-specific polyetheretherketone implants has now become a more widely applied method in maxillofacial surgery.

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Objectives: Scleroderma is a heterogeneous chronic autoimmune disease affecting connective tissue, characterised by chronic inflammation and fibrosis, particularly affecting internal organs and skin. Orofacial involvement is common, leading to facial atrophy, mask-like appearance and difficulties in function that significantly impact patients' quality of life. This systematic review evaluates different autologous regenerative treatments of facial manifestations of scleroderma, aiming to provide comprehensive understanding of their effectiveness in reducing fibrosis, and thereby improving function and skin quality.

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Clinical indications for adipose tissue therapy are expanding towards a regenerative-based approach. Adipose-derived stromal vascular fraction consists of extracellular matrix and all nonadipocyte cells such as connective tissue cells including fibroblasts, adipose-derived stromal cells (ASCs) and vascular cells. Tissue stromal vascular fraction (tSVF) is obtained by mechanical fractionation, forcing adipose tissue through a device with one or more small hole(s) or cutting blades between syringes.

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The aim of this study was to investigate the value of 3D Statistical Shape Modelling for orthognathic surgery planning. The goal was to objectify shape variations in the orthognathic population and differences between male and female patients by means of a statistical shape modelling method. Pre-operative CBCT scans of patients for whom 3D Virtual Surgical Plans (3D VSP) were developed at the University Medical Center Groningen between 2019 and 2020 were included.

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Article Synopsis
  • The study evaluated the effects of upper blepharoplasty on headaches, eyebrow height, and muscle activity in the frontalis and orbicularis oculi muscles.
  • Patients were divided into two groups: one received just skin removal (Group A) and the other had skin removal with additional muscle strip resection (Group B).
  • Results showed significant reductions in headache complaints post-surgery, no major differences in eyebrow height or muscle fatigue between the two groups, and slight changes in muscle activity mainly in Group A.
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Objective: to systematically review the efficacy of microfocused ultrasound (MFU) for facial skin tightening. Methods: A systematic search was performed (Pubmed, Embase) to assess the efficacy of single MFU treatments for facial skin tightening. Eligible studies included randomised controlled trials, controlled trials, cohort studies and case series (n ≥ 10).

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An important aesthetic goal in orthognathic planning is to improve facial balance, harmony, volume, and symmetry. It is therefore logical that adjunctive aesthetic procedures become a part of the overall orthognathic treatment plan and that their possibilities are discussed with orthognathic candidates. Such procedures help to improve the final outcome of the orthognathic treatment and enhance patient satisfaction.

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Background: Different skin excision shapes may result in different aesthetic outcomes after upper blepharoplasty.

Methods: Two skin-only excision shapes were evaluated objectively and subjectively in 28 matched patients with laterally extended skin excision (group A) or traditional elliptical skin excision (group B). The pretarsal show, lateral eyebrow height, amount of scarring (evaluated with the Patient and Observer Scar Assessment Scale), and patient-reported aesthetic results (evaluated using FACE-Q) were scored and compared at 6 and 12 months postoperatively.

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Background: Facial fat grafts decrease in volume after transplantation. This observation is based on overall facial three-dimensional analyses, because there is sparse information on volume changes in well-defined aesthetic areas. The authors aimed to assess the overall and, more specifically, the local volumetric effects of facial fat grafting and relate these effects to patient satisfaction up to 1 year after treatment.

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Background: For decades, facial fat grafting has been used in clinical practice for volume restoration. The main challenge of this technique is variable volume retention. The addition of supplements to augment fat grafts and increase volume retention has been reported in recent years.

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Article Synopsis
  • Upper blepharoplasty, a cosmetic eye surgery, may influence dry eye symptoms due to the role of the orbicularis oculi muscle in tear film management.
  • A clinical trial compared two techniques of upper blepharoplasty on 54 patients, one with muscle removal and one without, assessing various dry eye parameters before and after surgery.
  • While both techniques showed similar long-term results in tear dynamics, patients reported reduced dry eye symptoms post-surgery, indicating the surgery's subjective benefits regardless of the technique used.
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Article Synopsis
  • The study evaluated the reproducibility of 3D scanning in the periorbital area to objectively assess surgical outcomes.
  • Facial scans were performed on 15 volunteers using a handheld scanner, with measurements taken both shortly after and one year later, demonstrating very small deviations in measurements.
  • The findings indicate that 3D scanning is a reliable and accurate method for tracking changes in the periorbital region after surgery, as deviations stayed well within the clinically acceptable error margin of 1 mm.
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Three-dimensional stereophotogrammetry is commonly used to assess volumetric changes after facial procedures. A lack of clear landmarks in aesthetic regions complicates the reproduction of selected areas in sequential images. A three-dimensional volumetric analysis was developed based on a personalized aesthetic template.

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Weight gain can affect the volume of a facial fat graft, resulting in unfavorable asymmetries. Weight gain during pregnancy is more complex and does not just entail an increase in adipose tissue. This case report objectifies whether pregnancy results in volume changes of a facial fat graft.

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Purpose: Asymmetrical expansion occurs in patients treated with Surgically Assisted Rapid Maxillary Expansion (SARME). In the clinical setting, this asymmetrical expansion is seen in multiple directions. However, the frequency, actual directions and amount of asymmetry are unclear.

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Background: MRI is the optimal method for sensitive detection of tumour tissue and pre-operative staging in oral cancer. When jawbone resections are necessary, the current standard of care for oral tumour surgery in our hospital is 3D virtual planning from CT data. 3D printed jawbone cutting guides are designed from the CT data.

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Purpose Of Review: This review describes the advances in 3D virtual planning for mandibular and maxillary reconstruction surgical defects with full prosthetic rehabilitation. The primary purpose is to provide an overview of various techniques that apply 3D technology safely in primary and secondary reconstructive cases of patients suffering from head and neck cancer.

Recent Findings: Methods have been developed to overcome the problem of control over the margin during surgery while the crucial decision with regard to resection margin and planning of osteotomies were predetermined by virtual planning.

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Background: Reconstruction and oral rehabilitation of segmental maxillofacial defects resulting from ablative surgery is commonly achieved by osteocutaneous vascularized free fibula (VFFF) transplantation combined with implant-supported dental prostheses. We systematically reviewed the literature regarding impact of oral rehabilitation with or without dental implants on functional outcome and quality of life (Qol) following reconstruction of such segmental maxillofacial defects with VFFF.

Methods: This systematic review was performed according to the PRISMA guidelines.

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Background: We compared the pre-operative 3D-surgical plan with the surgical outcome of complex two-stage secondary reconstruction of maxillofacial defects using inserted implants in the prefabricated fibula graft.

Methods: Eleven reconstructions of maxillofacial defects with prefabricated fibulas were performed using a 3D virtual planning. Accuracy of placement of the fibula grafts and dental implants was compared to pre-operative 3D virtual plans by superimposing pre-operative and post-operative CT-scans: we first superimposed the CT-scans on the antagonist jaw, to represent the outcome of occlusion, and then superimposed on the planned fibula segments.

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Background: With the advents of new processing techniques and new graft survival theories in fat grafting, the question is: Which processing technique is of preference? This study systematically reviewed literature regarding current techniques for processing fat grafts.

Methods: PubMed, Embase, Cinahl, and Cochrane databases were searched until August 2015. Studies comparing different fat grafting processing techniques were included.

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