[SavageGlow]

Full facial osteomyocutaneous transplantation requires correct spatial alignment of the osseous structures to a new cranial base. Absolute alignment depends on the fidelity to the 6 degrees of freedom in which a body can move. Computer-assisted design and manufacturing (CAD/ CAM) has been proposed as a solution to diminish the intraoperative time requirements without sacrificing the quality of alignment during craniofacial and orthognathic surgery. Intraoperative splints created using CAD/CAM for traditional orthognathic surgery have been demonstrated to demand less operative time and produce reliable postoperative results. However, this method will also be deficient in the demands created by the emerging field of facial transplantation, in which an entire midface and mandible might be transplanted without fixed reference points other than a skull base.

Results: The postoperative fidelity to the plan was adequate to excellent (ICC 0.520 to 0.975) with the exception of lateral translation (2.94 ± 1.31 mm predicted left vs 3.92 ± 2.17 mm right actual displacement; ICC 0.243). The predicted and actual values were not consistently skewed toward the donor or recipient values.

Conclusions: We have demonstrated a novel application of CAD/CAM that enables orthognathic alignment of a maxillary-mandibular segment to a new cranial base. Quantification of the alignment in all 6 degrees of freedom delivers precise control compared with the planned changes and allows postoperative quality control.

[mintycbo]

[Pyramid_Head]

Modern medicine is wild.