The use of patient specific polyetheretherketone implants for reconstruction of maxillofacial deformities.

PURPOSE: The aim of this study was to evaluate polyetheretherketone (PEEK) as a patient-specific implant (PSI) material in maxillofacial reconstructive surgery. MATERIALS AND METHODS: The retrospective study included a cohort of 24 patients who underwent maxillofacial surgery using PEEK PSIs. Each patient underwent preoperative multislice computed tomography (CT) with 0° tilt of gantry. Based on the CT scan, the PEEK PSIs were planned and manufactured using three-dimensional (3D) modeling and computer-aided design/computer-aided manufacturing (CAD/CAM) techniques. All procedures were performed under general anesthesia. Implants were placed intraorally, extraorally or through subciliary, transconjuctival or coronal incisions. RESULTS: In 22 of 24 cases, the PEEK PSI fit well without adjustments. Although the fit to the surrounding bone was perfect in almost all of the cases, the outer contour of the PSI was modified in nine cases before fixation. However, intraoperative implant modification did not affect the infection rate. In two cases, postoperative wound dehiscence and infection needed additional treatment and healed without removal of the implants. CONCLUSION: The follow-up data in this study showed good outcomes with reliable results for PSI made of PEEK in the maxillofacial region.

Occurrence and types of dental injuries among patients with maxillofacial fractures.

The aim of this retrospective study was to clarify the occurrence and types of dental injuries in 389 patients who had been diagnosed with facial fractures, and to analyze whether the occurrence of dental injury correlates to gender, age, trauma mechanism and type of facial fracture. Dental injuries were observed in 62 patients (16%). The most common type of injury was a crown fracture (48%). Dental injuries were multiple in most patients (63%). Almost half (48%) of all injured teeth were severely injured. Most injured teeth (61%) were in the maxilla. The incisor region was the most prevalent site in both the mandible (45%) and the maxilla (56%). The occurrence of dental injury correlated significantly with trauma mechanism and fracture type: motor vehicle accidents and mandibular fracture were significant predictors for dental trauma. The notable rate of dental injury observed in the present study emphasizes the importance of a thorough examination of the oral cavity in all patients who have sustained facial fracture. Referral to a dental practice for further treatment and follow up as soon as possible after discharge from hospital is fundamental.