Three-dimensional Measuring of Zygomaticomaxillary Complex Symmetry after Fixation of Unilateral Zygomaticomaxillary Complex Fracture

Abstract

Purpose: to evaluate the symmetry of the reduced unilateral zygomaticomaxillary complex (ZMC) fractures fixed with computer designed custom machined titanium miniplate and conventional titanium miniplate, using three dimensional computed tomography (3D-CT) analysis of ZMC position. Patients and Methods: Ten patients who suffered from unilateral ZMC fractured were involved in this study. The patients were randomly and equally divided into two groups. In group A, the ZMC fractures were reduced and fixed with computer designed custom machined titanium miniplates, whereas in group B, they were fixed by conventional 2.0mm titanium miniplates. Computed Tomography (CT) scan was performed for each patient pre and postoperatively, then imported as a Digital imaging communication in medicine (DICOM) to MIMICS software to make Standard tessellation language(STL) file for quantitative measurements, preoperative surgical planning was performed to group A for designing of custom made plates by mirror imaging of the unaffected side, segmentation and virtual reduction using PlastyCAD software, then fabrication of the final design of the plate by Computer numerically controlled (CNC) milling machines. Results: Clinical symmetry was achieved in all cases except two in group B. By radiographic analysis, there was a significant difference between the two groups. Group A showed smaller deviation from the unaffected side, indicating more adequate reduction in group A than group B. Conclusion: Custom made plate revealed adequate accuracy in restoring ZMC symmetry than conventional miniplates. The 3-D quantitative assessment used in this study successfully reflected symmetry levels Codex : 14/22.01 azhardentj@azhar.edu.eg http://adjg.journals.ekb.eg DOI: 10.21608/adjg.2021.64304.1342 Oral Medicine & Surgical Sciences (Oral Medicine, Oral & Maxillofacial Surgery, Oral Pathology, Oral Biology)