الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
The CMF trauma surgery is a challenging field due to the unique anatomy and the wide variety of injuries in head and neck region. The human history is facing an accelerating technological advancement in all fields of science and practice. It seems that technology is helping us again to heal some of these injuries in more efficient way. In late I 980s, the CAD and VSP was introduced using 3D imaging data in CT to produce prosthesis. The complexity of the different CMF trauma and availability of digital planning option created a need to use this technology in preoperative surgical planning to apply accurate restoration of the complex 3D form of the face. The use of VSP is used nowadays in different types of CMF surgery including recent trauma, old ones, midface, orthognathic, ZMC and others related to tumors’ resection with cutting guides and reconstruction. This role was increased mostly after the developing of CAM technology such as 3D printing. This has created innovative options for fabricating a new PSI to achieve better outcome. The need for digital planning before surgery is increasing but is it crucial in accuracy and perfect contouring of CMF surgery. Therefore, the aim of this study was to assess the effectiveness and efficiency of VSP in managing different types of maxillofacial trauma patients, the advantages and disadvantages of VSP, and the accuracy of 3D diagnostics as a preoperative planning tool. This prospective consecutive series study included 30 patients with different types of CMF trauma. All patients were subjected to detailed history taking, clinical Examination of face, CT assessment of the fracture’s fine cuts and routine preoperative investigations. Also, preoperative VSP, intraoperative and postoperative parameters assessment was done. ¨ Summary of Our Results Ø Age of the study participants ranged from 19 to 51 years with a mean age of 32.3 ± 8.82 years. 22 (73%) of the study participants were male and 8 (27%) were females. Ø Regarding the chronicity of the lesion in the study participants, it was recent road traffic accident (RTA) in 18 (60.0%) participants, old fracture in 10 (33.33%) participants, and tumors in 2 (6.67%) participants. Ø Regarding the type of included cases in the study participants, the most common type of trauma was orbital wall in 17 (57%) participants ZMC in 12 (40.0%) followed by frontal sinus fracture in 9 (30%) participants and 7 (23.33%) participants in mandibular fracture respectively. The least types of traumas were LE forte II in 3 (10.0%), LE forte III, LE forte I, NOE, tumors, and Orthognathic maxilla and mandible (MM) each occurring in 2 (7%) participants. Ø The actual OT after VSP using CAD and computer aided manufacturing was significantly lower than the expected time by traditional methods (p =0.008). Ø There was no significant difference between the actual number of incisions used after VSP using CAD and computer aided manufacturing and the expected number of incisions that is used in the traditional methods. Ø The overall patient satisfaction degree was very satisfied in 25 participants (83.33 %), satisfied in 3 participants (10 %), neither satisfied nor dissatisfied in 2 participants (6.67 %) and no one was dissatisfied or very dissatisfied. Ø Regarding anatomic outcome, 26 patients had perfect anatomic reduction (86.67%), 4 patients had basic anatomic reduction (13.33%) and no one had non anatomic reduction. Ø Regarding complication, scar alopecia occurred in 1 (3.3%), ectropion occurred in 1 (3.3%), temporary infraorbital hyposthesia 2 (6.7%), temporary unilateral temporal branch of facial hypothesia occurred in 1 (3.3%), seroma occurred in 1 (3.3%), and limited wound dehiscence occurred in 1(3.3%). Wound infection, plate extrusion, PSI reaction or rejection, Malunion, and delayed post operative malocclusion did not occur. ¨ Ø Regarding functional outcome, All the nineteen operated orbital wall fracture or reconstruction had an intact motility in all cardinal direction and an intact infraorbital sensation. All ten cases with mandibular intervention had a full range of mouth opening and normal occlusion. All patients with frontal sinus trauma or bone loss had regular contour and no affection of the supratrochlear or supraorbital nerves. Only one patient from nineteen patients, operated for ZMC and Le Forte, had irregular contour at the infraorbital region. Ø The surgical results were satisfactory. The reconstruction contour was checked through postoperative CT and the 3D reconstruction models which demonstrated good consistency between the virtual plan and achieved results. Ø The 3D mean deviation was 0.105 ± 0.198 mm.