Temporary intermaxillary fixation using individualized acrylic splints permits image-data-based surgery of the lower jaw and oropharynx. 2004

Jürgen Hoffmann, and Dirk Troitzsch, and Carsten Westendorff, and Octavio Weinhold, and Siegmar Reinert
Department of Oral and Maxillofacial Plastic Surgery, Tübingen University Hospital, Tübingen, Germany. juergen.hoffmann@uni-tuebingen.de

OBJECTIVE Image-data-based surgical navigation is used as a helpful device in the operating room to localize critical structures with a high degree of accuracy. It also enables physicians to plan therapeutic performance. Because it relies on preoperatively acquired computed tomography (CT) or magnetic resonance imaging (MRI) data, there is restricted access for navigation of surgical instruments in areas that show motion uncorrelated with radiologic data. Thus, in the case of moveable structures, for example the lower jaw, navigational procedures could not yet be applied. METHODS We introduce a new technique using individualized intermaxillary splints that fix the mandible in a reproducible aboccluded position at the time of image-data acquisition and surgery. METHODS Different manufacturing processes were investigated. The feasibility of uni- and bilateral intermaxillary splints was studied under clinical conditions in four patients during different procedures in the mandibular and oropharyngeal regions. RESULTS The manufacturing of the splints showed was easily performed in a short time. With bilateral fixation, there was a high anatomic target precision of 1.6 to 2.3 mm. CONCLUSIONS The use of bilateral intermaxillary splints that fix the patient's mandible in a reproducible aboccluded position permits an image-data-based navigated surgical approach to the oropharyngeal and mandibular regions.

UI MeSH Term Description Entries
D008334 Mandible The largest and strongest bone of the FACE constituting the lower jaw. It supports the lower teeth. Mylohyoid Groove,Mylohyoid Ridge,Groove, Mylohyoid,Grooves, Mylohyoid,Mandibles,Mylohyoid Grooves,Mylohyoid Ridges,Ridge, Mylohyoid,Ridges, Mylohyoid
D008437 Maxilla One of a pair of irregularly shaped bones that form the upper jaw. A maxillary bone provides tooth sockets for the superior teeth, forms part of the ORBIT, and contains the MAXILLARY SINUS. Maxillae,Maxillary Bone,Bone, Maxillary,Bones, Maxillary,Maxillary Bones,Maxillas
D009960 Oropharynx The middle portion of the pharynx that lies posterior to the mouth, inferior to the SOFT PALATE, and superior to the base of the tongue and EPIGLOTTIS. It has a digestive function as food passes from the mouth into the oropharynx before entering ESOPHAGUS. Oropharynxs
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D012371 Robotics The application of electronic, computerized control systems to mechanical devices designed to perform human functions. Formerly restricted to industry, but nowadays applied to artificial organs controlled by bionic (bioelectronic) devices, like automated insulin pumps and other prostheses. Companion Robots,Humanoid Robots,Remote Operations (Robotics),Social Robots,Socially Assistive Robots,Telerobotics,Soft Robotics,Assistive Robot, Socially,Companion Robot,Humanoid Robot,Operation, Remote (Robotics),Operations, Remote (Robotics),Remote Operation (Robotics),Robot, Companion,Robot, Humanoid,Robot, Social,Robot, Socially Assistive,Robotic, Soft,Social Robot,Socially Assistive Robot,Soft Robotic
D013165 Splints Rigid or flexible appliances that are used to maintain a displaced or movable part in position, or to maintain the position of and protect an injured part. Dynamic Orthoses,Dynamic Splint,Dynamic Splinting,Dynamic Splints,Static Orthoses,Static Splint,Static Splinting,Static Splints,Dynamic Splintings,Splint,Splint, Dynamic,Splint, Static,Splinting, Dynamic,Splinting, Static,Splints, Dynamic,Splints, Static,Static Orthose
D013517 Otorhinolaryngologic Surgical Procedures Surgery performed on the ear and its parts, the nose and nasal cavity, or the throat, including surgery of the adenoids, tonsils, pharynx, and trachea. Otorhinolaryngologic Surgical Procedure,Otorhinolaryngological Surgical Procedures,Procedure, Otorhinolaryngologic Surgical,Procedures, Otorhinolaryngologic Surgical,Surgical Procedure, Otorhinolaryngologic,Surgical Procedures, Otorhinolaryngologic,Otorhinolaryngological Surgical Procedure,Procedure, Otorhinolaryngological Surgical,Procedures, Otorhinolaryngological Surgical,Surgical Procedure, Otorhinolaryngological,Surgical Procedures, Otorhinolaryngological
D014057 Tomography, X-Ray Computed Tomography using x-ray transmission and a computer algorithm to reconstruct the image. CAT Scan, X-Ray,CT Scan, X-Ray,Cine-CT,Computerized Tomography, X-Ray,Electron Beam Computed Tomography,Tomodensitometry,Tomography, Transmission Computed,X-Ray Tomography, Computed,CAT Scan, X Ray,CT X Ray,Computed Tomography, X-Ray,Computed X Ray Tomography,Computerized Tomography, X Ray,Electron Beam Tomography,Tomography, X Ray Computed,Tomography, X-Ray Computer Assisted,Tomography, X-Ray Computerized,Tomography, X-Ray Computerized Axial,Tomography, Xray Computed,X Ray Computerized Tomography,X Ray Tomography, Computed,X-Ray Computer Assisted Tomography,X-Ray Computerized Axial Tomography,Beam Tomography, Electron,CAT Scans, X-Ray,CT Scan, X Ray,CT Scans, X-Ray,CT X Rays,Cine CT,Computed Tomography, Transmission,Computed Tomography, X Ray,Computed Tomography, Xray,Computed X-Ray Tomography,Scan, X-Ray CAT,Scan, X-Ray CT,Scans, X-Ray CAT,Scans, X-Ray CT,Tomographies, Computed X-Ray,Tomography, Computed X-Ray,Tomography, Electron Beam,Tomography, X Ray Computer Assisted,Tomography, X Ray Computerized,Tomography, X Ray Computerized Axial,Transmission Computed Tomography,X Ray Computer Assisted Tomography,X Ray Computerized Axial Tomography,X Ray, CT,X Rays, CT,X-Ray CAT Scan,X-Ray CAT Scans,X-Ray CT Scan,X-Ray CT Scans,X-Ray Computed Tomography,X-Ray Computerized Tomography,Xray Computed Tomography
D019904 Polymethyl Methacrylate Polymerized methyl methacrylate monomers which are used as sheets, moulding, extrusion powders, surface coating resins, emulsion polymers, fibers, inks, and films (From International Labor Organization, 1983). This material is also used in tooth implants, bone cements, and hard corneal contact lenses. PMMA,Polymethylmethacrylate,Acron,Acrylic Bone Cement,CMW Bone Cement,Implast,Kallocryl K,Lucite,Methyl Acrylic Plastic,Palacos R,Palavit,Perspex,Plexiglas,Plexiglass,Poly(methyl methacrylate),Polymethyl Methacrylate, Isostatic,Polymethyl Methacrylate, Simplex Opaque,Polymethyl Methacrylate, Surgical Simplex Bone Cement, Ammonium Salt,Polymethyl Methacrylate, Surgical Simplex P,Polymethyl Methacrylate, Syndiostatic,Polymethylmetacrylate,Sol,Superacryl,Isostatic Polymethyl Methacrylate,Methacrylate, Polymethyl,Methacrylate, Syndiostatic Polymethyl,Syndiostatic Polymethyl Methacrylate
D021621 Imaging, Three-Dimensional The process of generating three-dimensional images by electronic, photographic, or other methods. For example, three-dimensional images can be generated by assembling multiple tomographic images with the aid of a computer, while photographic 3-D images (HOLOGRAPHY) can be made by exposing film to the interference pattern created when two laser light sources shine on an object. Computer-Assisted Three-Dimensional Imaging,Imaging, Three-Dimensional, Computer Assisted,3-D Image,3-D Imaging,Computer-Generated 3D Imaging,Three-Dimensional Image,Three-Dimensional Imaging, Computer Generated,3 D Image,3 D Imaging,3-D Images,3-D Imagings,3D Imaging, Computer-Generated,3D Imagings, Computer-Generated,Computer Assisted Three Dimensional Imaging,Computer Generated 3D Imaging,Computer-Assisted Three-Dimensional Imagings,Computer-Generated 3D Imagings,Image, 3-D,Image, Three-Dimensional,Images, 3-D,Images, Three-Dimensional,Imaging, 3-D,Imaging, Computer-Assisted Three-Dimensional,Imaging, Computer-Generated 3D,Imaging, Three Dimensional,Imagings, 3-D,Imagings, Computer-Assisted Three-Dimensional,Imagings, Computer-Generated 3D,Imagings, Three-Dimensional,Three Dimensional Image,Three Dimensional Imaging, Computer Generated,Three-Dimensional Images,Three-Dimensional Imaging,Three-Dimensional Imaging, Computer-Assisted,Three-Dimensional Imagings,Three-Dimensional Imagings, Computer-Assisted

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