Dental Asia Jul/Aug 2018

53 DENTAL ASIA JULY / AUGUST 2018 Behind the Scenes Fig. 5: 3D printed drill guide Fig. 6: Pre-prepared 3D milled titanium/resin prosthesis Fig. 10a-b: 3D milled titanium prostheses in place Fig. 8: At time of injury Fig. 9: 3D printing for planning Fig. 7: Implants and prosthesis in place. information to the patient, a drilling template is designed, and 3D printed (Fig. 5). This 3D-printed drilling template acts as an interface between the virtual and the physical, transferring the virtual plan to the patient’s mouth. This planning also enables a physical model of the jaw to be made with implants in place before surgery actually takes place - and this means that the patient’s bridgework can be completed before surgery and fitted immediately upon completion (Fig. 6). Treatment that used to take months can be completed in minutes (Fig. 7)! • Planning and dental implant surgery: Dr.AndrewDawoodandDr.SusanTanner. Case 3 Anew jaw, dental implants and replacement teeth following a shotgun injury to the face (Figs. 8-10). This patient received a dramatic shotgun injury to his jaw during a robbery in Nigeria, and was airlifted to London (Fig. 8). Three-dimensional printing allowed a replica of his jaws to be produced before surgery. The position of a vascularised bone graft to be taken from his shoulder blade was planned using the 3D model. The position of replacement teethwas also planned, and a Ƥxation plate prepared, all prior to surgery (Fig. 9). The patient received, to my knowledge the Ƥrst immediate jaw reconstructionwith simultaneous dental implant placement and provision of implant-supported dental bridgework. In the course of just one procedure, a vascularised bone graft was transferred from his shoulder to the jaw to Ƥt within the contour of the Ƥxation plate. Implants were placed into the new jaw, and a simple implants with supported prosthesis was Ƥtted, replacing themissing teeth, the gums and some of the supporting bone, providing suitable support for the lip, which was later further reconstructed using complex plastic surgery. Three months later, the temporary prosthesis was replaced with definitive dental bridgework based upon 3D milled titanium frameworks, Ƥtted to the dental implants (Figs. 10a-b). Fig. 10a • Maxillofacial surgery: Prof. IainHutchison • Implant surgery: Dr. Andrew Dawood • Implant prosthetics: Dr. Susan Tanner • Modelling: Dr. Veronique Sauret, Cavendish Imaging. Case 4 A three-dimensional printing performed for the planning of complex facial/dental implant surgery and oral/facial prostheses (Figs. 11-14). I was part of the team that developed the incredible facial prosthesis for cancer