Semmelweis I. sz. Gyermekgyógyászati Klinika
Alveolar cleft patients suffer from complex hard tissue dehiscences. The introduction of three-dimensional (3D) imaging technolgies helped to evaluate the exact anatomy of the defects. Combined with different softwares the treament of cleft patients became more accurate and predictable.
We present a digital workflow to plan secondary alvaolar bone grafting using a patient specific surgical template. The aim was to achieve a shorter operation time and a simpler surgical procedure.
As a first step a Cone Beam Computed Tomography (CBCT) scan was carried out for every patient. Afterwards we created the 3D model of the bony defect (3DSlicer software). The second step was to design a patient specific, three-dimensionally (3D) printed surgical template of the bone graft (Blender software). Both the defect model and the surgical template were fabricated by 3D printing using sterilisable materials.
We placed the cancellous bone harvested from the iliac crest into the surgical template and added a tissue adhesive (Tissucol, Baxter, NL). In such way the initially friable bone formed the shape of the pre-operatively designed surgical template. Subsequently the bone graft was positioned in the defect.
Using this surgical planning technique 10 cleft lip and palate patients underwent surgery (between 2016-2018) at the First Department of Pediatrics of Semmelweis University Budapest. The pre-operatively planned graft fitted the defect, no inter-operative complications occurred and the operation time decreased.
The pre-operative evaluation of the alveolar cleft and the planning of the bone graft lead to shorter operation time and enabled a simpler operation technique. Both softwares are free, which makes this planning method available.
Chronical pediatric diseaces