Fractures of the midface usually follow well-defined patterns, including Le Fort, zygomaticomaxillary complex (ZMC), and naso-orbito-ethmoidal (NOE). Yet, the most practical classification to build the foundations of virtual planning for this type of fractures acknowledges two main types: fractures that alter occlusion and fractures without occlusal impairment. The first group includes all Le Fort and combinations, including multipiece Le Fort with combined palatal and dentoalveolar and is characterized by alterations in the intercuspal relationship between dental arches. This group necessitates first to reestablish a functionally stable occlusion, and anatomical reduction is secondary; therefore, tools to optimize occlusion transferring in virtual planning, including virtual bone reduction, occlusion 3D printing and scanning, and occlusal splints or aligners play the prominent part. On the other hand, in occlusion-non-impairing trauma, anatomical reduction is an essential concept, being first established in the virtual project and then transferred to the operating room using image-guided surgery, while surgical guides play a less important role. This chapter provides a comprehensive explanation of various virtual planning techniques for the different classes of trauma affecting the midface.

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Virtual Planning and 3D Printing in Midfacial Trauma

  • Alessandro Tel,
  • Massimo Robiony

摘要

Fractures of the midface usually follow well-defined patterns, including Le Fort, zygomaticomaxillary complex (ZMC), and naso-orbito-ethmoidal (NOE). Yet, the most practical classification to build the foundations of virtual planning for this type of fractures acknowledges two main types: fractures that alter occlusion and fractures without occlusal impairment. The first group includes all Le Fort and combinations, including multipiece Le Fort with combined palatal and dentoalveolar and is characterized by alterations in the intercuspal relationship between dental arches. This group necessitates first to reestablish a functionally stable occlusion, and anatomical reduction is secondary; therefore, tools to optimize occlusion transferring in virtual planning, including virtual bone reduction, occlusion 3D printing and scanning, and occlusal splints or aligners play the prominent part. On the other hand, in occlusion-non-impairing trauma, anatomical reduction is an essential concept, being first established in the virtual project and then transferred to the operating room using image-guided surgery, while surgical guides play a less important role. This chapter provides a comprehensive explanation of various virtual planning techniques for the different classes of trauma affecting the midface.