Computer assisted individual osteotomy design for mandibular reconstruction

The complex structure and functional capacity of the mandible places high demands on the design for mandibular reconstructions for graft or transplant purposes. When using the crista iliac as a basis for grafts to bridge large defects, the graft is empirically shaped by the surgeon according to his experience, whereby it is often necessary to dissect and reconstruct it numerous times. A 3-D computer tomogram of the lower jaw and ilium is carried out on patients undergoing a planned mandible reconstruction. The 3-D CT data are processed in a workstation using a medical image analysis system. The ala of the ilium is superimposed over the region of the lower jaw which is to be replaced. This enables a coincidence of the structure of the lower jaw and the structure of the ilium crest to be formed to within an accuracy of one voxel - despite the complex three dimensional structure and distortions in all three spatial planes. In accordance with the computer simulation, the applicably shaped ilium crest is placed on the individually calculated donor site and transplanted in the resected section of the lower jaw. An exact reconstruction of the lower jaw bone is made possible using computer assisted individual osteotomy design, resulting in complete restoration regarding shape and functionality.