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Custom-Made Titanium Miniplates Associated With Ultrahigh-Molecular-Weight Polyethylene Graft in Orthognathic Surgery: An Adjunct to Maxillary Advancement

José Thiers Carneiro Júnior, Paulo Hemerson de Moraes, Douglas Voss de Oliveira, Nayara Cristina Monteiro Carneiro
Journal of Oral and Maxillofacial Surgery 2018, 76 (5): 1091.e1-1091.e8
Patients with considerable maxillomandibular anteroposterior discrepancies and maxillary hypoplasia require corrective treatment through orthognathic surgery. However, in the treatment of severe maxillary retrognathism, it is necessary to reconstruct areas of bone deficiency through grafting techniques in addition to maxillary advancement using only the Le Fort I osteotomy. Treatment in these patients is more challenging and requires high surgical predictability. Alloplastic materials often have been used for the reconstruction of poor bone contours. Ultrahigh-molecular-weight polyethylene (UHMWPE) is currently an excellent filler material for poor bone regions and is a good substitute for autografts and other alloplastic materials for its unique properties, including high biocompatibility. Insertion of this material in the fixation system customized for virtually planned orthognathic surgeries is an innovative technique. This report describes the insertion of UHMWPE into custom-made titanium miniplates manufactured by computer-aided design and computer-aided manufacturing technology for orthognathic surgery consisting of maxillary advancement and mandibular retrusion to treat a patient with Crouzon syndrome, Class III malocclusion, and severe maxillary retrognathism.

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