Design of a three dimensional guide (3D) guide for occlusion restoration in a patient with a mandibular condylar fracture. Preliminary results and challenges of implementing digital technology in the public service.

Abstract

Mandibular fractures are common when the necessary conditions are present . If open surgical treatment is indicated, with fixation
of the fractured bones with plates and screws, occlusal restoration is mandatory. The public service is the place for resolving a large part of this demand for surgical patients and the insertion of three-dimensional (3D) technology has become imperative, as it helps immensely in surgical planning, increasing the degree of bone repositioning and consequently reducing treatment failure rates and the potential need to reoperate the patient. The installation of the Erich Bar is the gold standard for achieving original occlusion, and in its installation, due to the handling of steel wires, the risk of injury and cross-contamination still represents a major occupational risk for the surgeon. In the diagnosis of mandibular fractures, computed tomography has stood out as the complementary exam that adds the most information to the clinical examination, allowing the surgeon to visualize the fracture, even in three dimensions (3D), greatly facilitating surgical planning and tactics. This study describes the steps involved in designing a virtual occlusal restoration guide, manufacturing it on a 3D printer and using it to treat a patient with a condylar fracture for which surgery is indi-
cated. Initial results, future needs and challenges will also be discussed.