Page 51 - Craniomaxillofacial Implant Surgery - Jeroen P.J. Dings

Reliability and accuracy of surgical templates for craniofacial implant placement
optimal fit between the inner surface of the template and skin surface of the concerned anatomical region. Cylindrical openings were designed in all surgical templates to allow installation of the stainless-steel guide sleeves, through which the bone bed was prepared. No relevant 3D-inaccuracies of the templates in comparison with the 3D-virtual models were determined, as measured with a high-accuracy non-contact 3D digitizer (Konica Minolta Vivid 910).
Auricular templates contained several extensions facilitating correct positioning of 3 the template on the skin taking into account the supine position of the patient during
implant surgery. Extensions of the template included an anterior arm extending over
the zygomatic arch, orbital rim, and nasal bone to ensure support of regions that
were covered by the least amount of mobile tissue. In order to reduce flexibility of the surgical template a connecting arm was designed from the nasal bone to the auricular region. To ensure visual control of an optimal fit of the surgical template the temporal region was not covered. Furthermore an distal extension was incorporated extending to the occipital region (fig. 1)
The surgical template for nasal implants was designed with bilateral extensions over the malar bone and zygomatic arch and one superior extension to the nasal bone (fig. 2). The surgical template for the orbital region encompassed the superior, lateral, and inferior lateral rim with extensions to the nasal bone, malar bone, and zygomatic arch (fig. 3). Temporary transcutaneous bone-fixation pins were incorporated in the planning and equally distributed with position on the malar, nasal, frontal, temporal and occipital bone (fig. 4-6).
49