Chepurny Y. V., Chernohorskiy D. M., Zhukovtseva A. I., Kopchak A. V.

DENTISTRY

Scentific article

Abstract. The use of computer simulation in the planning of surgical operations has changed the protocols for the treatment of defects and deformities of the orbit and zygomatic complex (ZC). At the same time, the effectiveness of this approach in terms of the precision of reproducing the position of patient-specific implants (PSI), determined during preoperative planning, is still uncertain. Therefore, the purpose of this study was to study the correspondence between the position of the PSI achieved during the operation and its position planned during the preoperative computer simulation. Materials and methods. To achieve this goal, a comparative analysis of preoperative planning and postoperative results achieved in the treatment of 115 patients with ZC and / or orbital defects using PSI was carried out. In order to compare the preoperative planning and the obtained position of the PSI, the postoperative CT was segmented and virtual models of the ZC with the installed PSI were obtained. For further comparison, the virtual ZC model obtained from the data of preoperative CT was combined with the virtual model of the PSI. Then, in the Geomagic Freeform software environment, they were superimposed on each other in an automatic mode, where the software complex differentiated the corresponding points of both models, determined the average distance between them in “mm” and formed a color map of discrepancies of the superimposed images, which demonstrated the existing deviations between the models. The maximum deviations between similar points of the models were also measured. Results. The average deviation between the position of the PSI after reconstruction and its planned location was 1.2 ± 0.4 mm. The maximum deviation in the real position of the implants was 6.9 ± 2.1 mm. Evaluation of the accuracy of orbital volume restoration in patients included in the study showed that the mean planned orbital volume was 28.3 ± 2.8 cm3, while after reconstruction it was 28.6 ± 3.1 cm3 (p = 0.334). The average difference between the planned volume of the reconstructed orbit and the actually reproduced one was 0.6 ± 0.2 cm3. Conclusions. This study has confirmed the high reproducibility of virtual simulation and computer modeling in the treatment of ZC defects using CAD / CAM technology. The main reasons for deviations in the position of the implants were inaccurate virtual restoration of the integrity of the anatomical structures, the discrepancy between the design of the PSI and the surgical intervention plan, as well as errors in the surgical technique during the placement of implants and their fixation.

orbital reconstruction, zygomatic complex, patient-specific implants.

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«Bulletin of problems biology and medicine» Issue 2 (160), 2021 year, 327-331 pages, index UDK 616.716.1+616.714.7]-089.843-77-089.163-089.168]-042.2

10.29254/2077-4214-2021-2-160-327-331