Clinical efficacy of endoscopic-assisted polyether ether ketone patient-specific implant revision for over-resected mandibles following mandibular angle osteotomy
10.3760/cma.j.cn114657-20250303-00049
- VernacularTitle:内窥镜辅助聚醚醚酮个性化植入体修复下颌角截骨术后缺损疗效评价
- Author:
Shunchao YAN
1
;
Chongxu QIAO
1
;
Zai SHI
1
;
Jingyi XU
1
;
Kaili YAN
1
;
Yuming QU
1
;
Shu WANG
1
;
Wensong SHANGGUAN
1
;
Guoping WU
1
Author Information
1. 南京医科大学友谊整形外科医院整形外科，南京 210029
- Publication Type:Journal Article
- Keywords:
Polyether ether ketone;
Patient-specific implant;
Mandibular angle osteotomy;
Endoscope;
Maxillofacial reconstruction
- From:
Chinese Journal of Medical Aesthetics and Cosmetology
2025;31(6):575-580
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the clinical outcomes of endoscopic-assisted polyether ether ketone (PEEK) patient-specific implant (PSI) revision for over-resected mandibles caused by the mandibular angle osteotomy.Methods:A retrospective analysis was conducted on 24 patients [8 males, 16 females, aged 19-57 (32.5±9.5) years] with 39 over-resected mandibles that underwent PEEK-PSI mandibular angle revision surgery at the Affiliated Friendship Plastic Surgery Hospital of Nanjing Medical University from January 2019 to December 2023. Preoperative cone-beam computed tomography (CBCT) data were used to design and fabricate customized PEEK PSIs based on individual anatomical requirements. An intraoral incision approach with endoscopic assistance was employed to meticulously dissect soft tissue attachment around the angle region, followed by the implantation of a customized PEEK PSI. Postoperative CBCT scans were performed for 3D reconstruction, with root mean square error (RMSE) and maximum deviation (MaxD) as accuracy metrics. Patients′ satisfaction was assessed preoperatively and ≥6 months postoperatively using the face questionnaire (FACE-Q) scores, which included overall facial appearance, lower face and jawline, appearance distress, psychological health and social function.Results:All 24 patients achieved satisfactory recovery with primary healing of intraoral incisions. No complications such as infection, nerve injury, or implant rejection occurred during follow-up period. Patients′ facial appearance and jaw line contouring were significantly improved. Fine anatomical fitting between PEEK-PSI and defect areas was observed: RMSE ranged from 0.117 to 0.315 mm, and MaxD was (5.485±1.300) mm. FACE-Q scores demonstrated significant improvements after surgery in overall facial appearance [(49.8±5.4) vs (65.0±5.3) scores], lower face and jawline [(42.5±5.3) vs (56.1±4.6) scores], appearance distress [(60.0±6.9) vs (70.6±6.5) scores], psychological health [(62.0±5.0) vs (70.8±5.3) scores], and social function [(60.3±4.3) vs (69.3±5.8) scores] (all P<0.001). Conclusion:Endoscopic-assisted PEEK-PSI revision for over-resected mandibles following mandibular angle osteotomy exhibits high surgical precision and safety, effectively restoring mandibular contour and significantly enhancing patients′ satisfaction.
