OBJECTIVES

To determine and group the anthropometric norms of the zygomaticomaxillary (ZM) fixation points as a basis for optimizing the design of maxillary L-plates, from a sample population aged 19 to 59, in a tertiary government hospital in Central Luzon, Philippines.

METHODS

Design: Retrospective Review of CT scans

Setting: Tertiary Government Training Hospital

Participants: CT scan images of 110 surgical patients from the Department of ORL-HNS, obtained between January 2023 and December 2024 were measured

RESULTS

A total of 169 maxillae were analyzed, comprising 85 right and 84 left sides. The maxillary width (MW) of males (30.59 ± 2.86 mm) was found to be wider than the MW of females (29.68 ± 2.69 mm) by 0.91 mm. The zygomatic width (ZW) and its inclination angle (IA), on the other hand, were not significantly different. There were also no significant differences in the MW, ZW, and IA between the right and left sides; with the MW mean at 30.17 ± 2.81 mm and a range of 24.40 36.80 mm, the ZW mean at 20.22 ± 2.47 mm and a range of 15.40–28.30 mm, and the IA mean at 111.13 ± 11.29 degrees and a range of 78.50–131.70 degrees. To capture the range of maxillary sizes among patients, a quartile-based grouping was introduced. The MW, ZW, and IA of the L-plates were classified into small (27.80 mm, 18.30 mm, 104.15 degrees), medium (29.80 mm, 19.90 mm, 110.70 degrees), and large (32.35 mm, 22.05 mm, 120.20 degrees) sizes, respectively.

CONCLUSION

This study established reference values for the MW, ZW and IA to optimize the maxillary L-plate design for ZM fractures. The novel quartile-based grouping provided options for future L-plate measurements – potentially creating a better fit for patients, streamlining design in implant production, and improving the efficiency and outcomes of maxillofacial surgeons.

Human ; Maxillary Fractures ; Tomography ; Titanium ; Fracture Fixation

Objective: To present our in-house 3D planning protocol utilizing open-source computer-aided design software and discuss specific applications in reconstruction of various craniomaxillofacial defects, demonstrating a free, accessible, efficient, accurate, and easily learnable alternative to expensive counterparts. Methods: Design: Case Series. Setting: Tertiary Private Training Hospital. Participants: Ten (10) patients who underwent CAD assisted reconstructive surgeries from February 2017 – May 2018. Results: A total of 10 patients were included; 7 mandibular reconstructions were surgically reconstructed using our 3D planning protocol and achieved symmetric mandibular contour, with good functional occlusion after surgery; 1 cranioplasty and 1 orbital trauma case also achieved good symmetry and adequate correction of enophthalmos respectively. However, inadequate soft tissue correction was seen in 1 case of maxillary reconstruction despite achieving symmetric bony contour. Conclusion Our 3D planning protocol using open-source CAD applications is a viable alternative to expensive professional counterparts. Additional prospective studies may better demonstrate benefits in terms of accuracy and decreasing intraoperative time in craniomaxillofacial and head and neck reconstruction.
Computer-Aided Design