Abstract Prof. Takahiro Kanno

Abstract

Recent innovations in the era of advanced digital technology in oral and maxillofacial surgery, such as digital computer-assisted surgical planning and intraoperative navigation, could improve the efficacy, precision, and predictability of surgical treatments of such oral tumor, oral cancer resection and oral-maxillofacial reconstruction together with dental implant rehabilitation. Given the developments in high-definition imaging and three-dimensional (3D) printing, the bioengineer and the surgeon can together visualize the tumor on a screen and print a restorative prototype that reflects the individual needs of the patient. The precise location of osteotomy for segmental or marginal mandibulectomy can be determined and translated to the theater as 3D-printed cutting guides, which greatly improves efficiency and accuracy. In addition, the contour and dimensions of the new defect can be transferred to donor sites, such as the fibula, the scapula or the iliac crest. Another surgical guide can be used when harvesting and shaping donor tissue for the recipient area. Furthermore, the manufacture of individualized reconstruction plate systems is now available. Taken together, oral rehabilitation using dental implants can be well applicable incorporating these advanced digital technology based reconstruction techniques. In July 2020, the Japanese National Health Insurance commenced coverage of computer-aided patient-specific mandibular reconstruction plate system for cases with advanced benign and malignant pathologies. We immediately embraced this technology into our oral tumor patients as Japanese new frontier. Here, we would like to present the workflow associated with the resection of aggressive oral cancers and benign oral tumors such as ameloblastoma using the virtually precisely planned cutting guides and the individualized patient-specific reconstruction plate system with/without vascularized flap reconstructions such as fibula flap/pectoralis major myocutaneous flap for oral-maxillofacial reconstruction and oral rehabilitation using dental implants. We have applied this innovative novel system for eighteen advanced oral cancer and oral tumor patients so far. I am greatly honored and happy to share and discuss with you all, APIS members.