Research Publications

Abstract: Crouzon syndrome, also known as craniofacial dysostosis,
is an autosomal dominant inherited disease characterized by early cranial fusion and consequential craniofacial malformations.
In patients with Crouzon syndrome, the growth of the midface is
affected due to early fusion of the cranial base, which results in
exophthalmos, ocular ptosis, midface deficiency, and maxillary
retrognathism. Frontofacial advancement using Le Fort III osteotomy
is the conventional method for treating patients with Crouzon
syndrome. However, this procedure has drawbacks such as extensive
operation field and high possibility of serious complications
(eg, meningitis). For patients with mild symptoms, facial esthetics
and proper occlusion can be promoted through conventional orthognathic
surgery, but midface deficiency cannot be completely
resolved. Thus, in this case report, midface augmentation was
performed for a patient with Crouzon syndrome by undergoing
conventional orthognathic surgery, along with patient-specific
implants made using a 3D virtual technique. Implants were 3D
printed using polyetherketoneketone and simultaneously implanted
during the orthognathic surgery. After the surgery, not only were the
patient’s occlusion and facial esthetics improved, but also
exophthalmos and ocular ptosis were reduced by the midfacial
augmentation effect of patient-specific implants placed in the
midface. Since the implants were made exactly as what surgeons
have intended through computer-aided design (CAD)/computeraided
manufacturing (CAM) and 3D printing techniques, problems
such as under-/over-correction were avoided. In addition, the
possibility of implant malpositioning was minimized using surgical
stents as implants were passively fitted on the patient’s bone
surface. This case verified that the application of 3D technology
to the field of oral and maxillofacial surgery can reduce the
invasiveness of surgery and improve the accuracy of the operation.
Therefore, by using cutting-edge technologies, the field of oral and
maxillofacial surgery is expected to be developed further in the near
future.

Key Words: 3D virtual technology, Crouzon syndrome, midface
augmentation, patient-specific implant