Accuracy and clinical evaluation of computer-aided surgery in management of maxillofacial fractures after trauma

Management of maxillofacial fractures is a challenging situation for surgeon. This clinical study aimed to evaluate management of various types, involving complex fractures in the face and head region, in terms of accuracy and clinical outcomes. Included patients were treated using CAD/CAM techniques. A voxel-based analysis was carried out to evaluate the pre-/postoperative accuracy for each patient by superimposing the preoperative planning with the data for the postoperative CT. The distances between the preoperative, virtually planned, and postoperative positions of the screw holes of custom plates were compared. Additionally, various specifics, such as number of reduction guides/plates and surgical accesses, operating times, and perioperative complications were evaluated. Nine patients were included. The median accuracy, measured in millimeters by superimposing the planning with postoperative CT results, was 1.420 (standard deviation 0.425). The surgical times ranged between 100 and 620 min. Complications were seen in three patients; these included preoperative breakage of one reduction guide, and difficulty in intraoperative positioning of the plates in two patients. In conclusion, CAD/CAM techniques in the treatment of a variety of maxillofacial fractures can be beneficial; however, there is a lack of information in the literature, and more studies are needed to confirm these results.