Lawrence Brecht, David Hirsch: Jaw in a day - one stage complete jaw rehabilitation for the mandible and maxilla
- CASS - computer aided surgery simulation with prefabricated cutting guides and models
- Minimize operative time and maximize precision
- Immediate form and function reconstruction for immediate gain in patient quality of life and self-esteem
- Presentation and review of treatment protocol step by step
The traditional free hand fibula-based reconstruction has evolved into a computer-aided simulation (CASS), minimizing operative time and maximizing precision. Dr Brecht and Dr Hirsch present CASS based treatment protocols and procedures for a one-stage surgical reconstruction of severe maxilla and mandible defects - jaw in a day - and lead step-by-step through the planning, prosthesis design&modelling and surgical treatment phases. It is important to think functional and from an occlusal perspective downwards and reverse-engineer the tissue reconstruction from 'top-down'. Supported with patient treatment examples, the lecturers review implant placement in the fibula, use of prefabricated cutting guides, fibula resection, maxillo-mandibular fixation and immediate placement of a screw-retained prosthesis. Prosthetic reconstruction and implant position define the way the fibula bone is going to be bent. The soft tissue pedicle with peroneal vessels is transferred to the neck vessels. The lecturers conclude, that using this immediate reconstruction technique it is possible to restore form and function immediately, to reduce overall treatment time and cost, and as an invaluable benefit, that patients leave the hospital feeling whole again.
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