Application of Personalized 3D-Printed Rehabilitation Orthotics in Postoperative Recovery of Jaw Fractures

Objective:To analyze the effectiveness of personalized 3D-printed rehabilitation orthotics in the postoperative recovery of jaw fractures.Methods:Relevant data were collected from 42 patients with jaw fractures treated at our hospital between October 2017 and May 2020.Patients were randomly divided into a traditional group(n=17)and a modified group(n=25).The traditional group received standard rehabilitation methods,while the modified group used personalized 3D-printed rehabilitation orthotics combined with improved rehabilitation methods.The temporomandibular disability index(TDI),quality of life scores,postoperative recovery excellence rate,and mouth opening were compared between the two groups at different follow-up times(before rehabilitation,and at 1 week,3 months,and 6 months post-surgery).Results:At 1 week,3 months,and 6 months post-surgery,the TDI in both the traditional and modified groups was significantly lower than before rehabilitation,with statistically significant differences(P<0.05).At 3 and 6 months post-surgery,the TDI in the modified group was lower than in the traditional group,with statistically significant differences(P<0.05).At 3 and 6 months post-surgery,pain,appearance,activity,recreation,work,chewing,swallowing,speech,shoulder function,and total quality of life scores in both groups were higher than before rehabilitation,with the modified group showing significantly higher scores in pain,appearance,chewing,swallowing,and total quality of life(P<0.05).Compared to before rehabilitation,mouth opening significantly improved in both groups at 3 and 6 months post-surgery,with the modified group showing significantly greater improvement(P<0.05).Conclusion:Personalized 3D-printed rehabilitation orthotics are highly effective in the postoperative recovery of jaw fractures.They can improve patients’quality of life after surgery,enhance the excellent rate of postoperative recovery,and increase mouth opening.

A retrospective study of occlusal reconstruction in patients with old jaw fractures and dentition defects

Purpose:This study evaluated the methods and clinical effects of multidisciplinary collaborative treatment for occlusal reconstruction in patients with old jaw fractures and dentition defects.Methods:Patients with old jaw fractures and dentition defects who underwent occlusal reconstruction at the Third Affiliated Hospital of Air Force Military Medical University from January 2018 to December 2022 were enrolled.Clinical treatment was classified into 3 phases.In phase I,techniques such as orthognathic surgery,microsurgery,and distraction osteogenesis were employed to reconstruct the correct 3-dimensional(3D)jaw position relationship.In phase II,bone augmentation and soft tissue management techniques were utilized to address insufficient alveolar bone mass and poor gingival soft tissue conditions.In phase III,implant-supported overdentures or fixed dentures were used for occlusal reconstruction.A summary of treatment methods,clinical efficacy evaluation,comparative analysis of imageological examinations,and satisfaction questionnaire survey were utilized to evaluate the therapeutic efficacy in patients with traumatic old jaw fractures and dentition defects.All data are summarized using the arithmetic mean±standard deviation and compared using independent samplet-tests.Results:In 15 patients with old jaw fractures and dentition defects(an average age of 32 years,ranging from 18 to 53 years),there were 7 cases of malocclusion of single maxillary fracture,6 of malocclusion of single mandible fracture,and 2 of malocclusion of both maxillary and mandible fractures.There were 5 patients with single maxillary dentition defects,2 with single mandibular dentition defects,and 8 with both maxillary and mandibular dentition defects.To reconstruct the correct 3D jaw positional relationship,5 patients underwent Le Fort I osteotomy of the maxilla,3 underwent bilateral sagittal split ramus osteotomy of the mandible,4 underwent open reduction and internal fixation for old jaw fractures,3 underwent temporomandibular joint surgery,and 4 underwent distraction osteogenesis.All patients underwent jawbone augmentation,of whom 4 patients underwent a free composite vascularized bone flap(26.66%)and the remaining patients underwent local alveolar bone augmentation.Free gingival graft and connective tissue graft were the main methods for soft tissue augmentation(73.33%).The 15 patients received 81 implants,of whom 11 patients received implant-supported fixed dentures and 4 received implant-supported removable dentures.The survival rate of all implants was 93.82%.The final imageological examination of 15 patients confirmed that the malocclusion was corrected,and the clinical treatment ultimately achieved occlusal function reconstruction.The patient satisfaction questionnaire survey showed that they were satisfied with the efficacy,phonetics,aesthetics,and comfort after treatment.Conclusion:Occlusal reconstruction of old jaw fractures and dentition defects requires a phased sequential comprehensive treatment,consisting of 3D spatial jaw correction,alveolar bone augmentation and soft tissue augmentation,and implant-supported occlusal reconstruction,achieving satisfactory clinical therapeutic efficacy.