The role of MRI and 3D modelling of the mandible in assisting personalised reconstructive surgery

Abstract

Mandibular trauma contributes to a large proportion of maxillofacial injuries. The mandible holds a key role in mastication, communication, and appearance and there­fore severe injury can be highly disfiguring, disabling and distressing for patients. The primary treatment option for the majority of mandibular fractures is surgical inter­vention using an open reduction and internal fixation technique (ORIF). Increasing the personalisation of re­constructive surgery is important in ensuring effective rehabilitation and high patient satisfaction. Magnetic Resonance Imaging (MRI) provides an accurate method of visualising the mandible without exposing patients to harmful radiation. In conjunction with radiography, 3D modelling techniques can produce personalised models with the potential to aid pre-operative planning and the development of mandibular implants. The project used a Bio-CAD image-based modelling technique. Firstly, Head and Neck MRI scans were performed on two subjects. Images received from these scans were imported into the Simpleware ScanIP software whereby computer-aid­ed design helped to generate several STL files for 3D printing. Using Fused Deposition Modelling and stere­olithography, personalised 3D models of the mandible are printed for both subjects. Finite Element Analysis is then performed on the models to assess the biomechanics of mastication and the stresses endured by the mandible. Utilisation of these models in the future could lead to increased surgical success and improved patient care.

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