If you’re past a certain age – really, if you’re old enough to read this – the odds are good that you’ve had some kind of dental work done at some point in your life. It’s also likely that whatever work you’ve had done has been painful. Maybe not at the time – thanks, anesthesia! – but once the drugs wear off, you’re left with an aching jaw that is anywhere from annoying to misery-inducing. I had all four of my wisdom teeth out at once, and the week following the procedure was not pleasant in the least. Tooth/jaw pain affects you in ways that other pain does not; you can stay off an injured leg, but you’ve got to eat, and talk, and when those actions cause excruciating pain, life can get pretty rough indeed.
Now imagine living with pain in your jaw for seven years. I can hardly imagine it, personally, but that’s what Tan Seng Yam had to deal with. When he first noticed the swelling near his jaw, doctors and dentists told him it was nothing to worry about, but it persisted until finally, years later, he was unable to eat. Seng Yam then went to a specialist, who discovered that the swelling was caused by a tumor in his jawbone.
Seng Yam was referred to Hospital Kuala Lumpur, where surgeons concluded that the only solution was a complex surgery that would remove the tumorous section of Seng Yam’s jawbone and replace it with bone taken from his fibula – the long bone in the calf.
“Mandible reconstruction via fibula bone grafting is a fairly complex surgery,” said Dato’ Dr. Wan Mahadzir bin Wan Mustafa, Senior Consultant at the Department of Oral and Maxillofacial Surgery. “For fibula grafting, precision while cutting is very important and time-demanding.”
We’ve covered a lot of instances where 3D printed surgical models have helped doctors prepare for difficult surgeries. As the technique has become more prevalent, the technology has gotten more advanced, with specially designed software enabling surgeons to perform the surgery in a virtual setting. In Seng Yam’s case, it was Materialise’s PROPLAN CMF pre-surgical planning software that allowed his doctors to carefully plan the operation. Dr. Wan enlisted the help of Dr. Sun Jian and Dr. Xu Li Qun from Shanghai Ninth People’s Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine. Both doctors were experienced in using the Materialise software and in creating 3D printed surgical guides, so they stepped in to collaborate on the procedure.
With help from the software, the doctors were able to create very precise, customized surgical guides based on Seng Yan’s anatomy. Those guides were then printed by Materialise. Once in the operating room, Dr. Wan and his colleagues were able to operate with much more confidence and accuracy, having already gone through the procedure virtually. The 3D surgical guides told them exactly where to cut, and the surgery was, according to Dr. Xu, “near perfection.”
“Without this technology, virtual planning and surgical guides, it’s a lot like eye-balling,” Dr. Wan said. “That translates to more time in surgery. And often longer surgery time means more recovery time.”
Seng Yam had quite a bit of work to do for his recovery anyway. He had to “train” his mouth to work with an entirely new jawbone, and he also had to practice walking, as a portion of his leg bone had been removed. Within a few weeks, however, he was feeling pretty good. The swelling is gone, and he can eat solid foods again without much discomfort. His surgery was the first at Hospital Kuala Lumpur to be performed with help from 3D surgical guides. Dr. Wan hopes that a growing awareness of the technology’s benefits will lead to wider use within medical institutions, because the benefit to patients is invaluable.
“We had a very similar surgery the day after,” he said, “and it would have taken much less time with 3D virtual planning.”
Discuss your thoughts on the impact of this new surgical pre-planning tool in the Materialise 3D PROPLAN CM forum over at 3DPB.com.[Images: Materialise]