Purpose: To demonstrate use of patient specific implants (PSIs) in the reconstruction of significant facial skeletal defects. Polyamide 12 implants were used to achieve good symmetric results with great projection and contours and minimal morbidity, all of which would not be predictably achievable with other reconstructive options.
Methods: Using a retrospective study design, three patients who had significant facial skeletal defects affecting the zygomaticomaxillary complex, frontal bone and also having an orbital component were used as subjects. The cases reported in this article were managed during the period from June 2015 to May 2016 with a minimum of 5 years follow up for all three cases. Outcomes were evaluated radiographically by overlapping postoperative x-rays with the virtual plan and also clinically using a virtual analogue scale (VAS).
Results: For the three patients, VAS assessment for patient satisfaction yielded promising results with the first case reporting an 8, with 10 being most satisfied. For the second patient, the VAS was 7.5 and for the third patient it was 8.5. Radiographically, the difference in transverse projection on all four points did not exceed 2.48 mm. When assessing antero-posterior projection accuracy, there was an average deviation of 0.68 mm at the infraorbital rim and 0.86 mm at the zygomaticofrontal point.
Conclusion: This article aims to point out the significant advantages of the use of polyamide 12 PSIs for the major facial skeletal reconstructions regarding symmetry, anatomical contours, minimal morbidity and decreased costs. A larger number of patients is needed in future studies.
Keywords: CAD/CAM; Maxillofacial reconstruction; Midface reconstruction; PSI.
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