Template-Based Orbital Wall Fracture Treatment Using Statistical Shape Analysis

J Oral Maxillofac Surg. 2017 Jul;75(7):1475.e1-1475.e8. doi: 10.1016/j.joms.2017.03.048. Epub 2017 Apr 4.

Abstract

Purpose: Aim of this study was to investigate whether a mold generated from a statistical shape model of the orbit could be generated to provide a cost-efficient means for the treatment of orbital fractures.

Materials and methods: A statistical shape model was created from 131 computed tomographic (CT) scans of unaffected adult middle European human orbits. To generate the model, CT scans were segmented in Brainlab software, preregistered using anatomic landmarks, trimmed to an identical size, and definitely registered. Then, the model was created using the global master algorithm. Based on this model, a mold consisting of a male part and a female part was constructed and printed using a rapid prototyping technique.

Results: A statistical shape model of the human orbit was generated from 125 CT scans. Six scans (4.5%) presented major anatomic deviations and were discarded. A solid mold based on this model was printed. Using this mold, flat titanium mesh could be successfully deformed to serve as an orbital implant.

Conclusion: A mold based on the statistical orbital shape could serve as a cost-effective means for the treatment of orbital fractures. It allows the anatomic preformation of titanium or resorbable implant material for orbital reconstruction. Because these materials could be cut from larger sheets, the use of a mold would be a cost-effective treatment alternative.

MeSH terms

  • Computer-Aided Design*
  • Cost-Benefit Analysis
  • Humans
  • Imaging, Three-Dimensional
  • Models, Anatomic*
  • Models, Statistical*
  • Orbit / anatomy & histology*
  • Orbit / diagnostic imaging
  • Orbit / surgery*
  • Orbital Fractures / economics
  • Orbital Fractures / surgery*
  • Prosthesis Design / methods*
  • Software
  • Tomography, X-Ray Computed