Virtual planning is ideally suited for maxillofacial operations as it allows the surgeon to assess the bony and critical neurovascular structures and enables him to plan osteotomies and fracture reductions. This study aims to propose the use of titanium-based patient-specific implants (PSI), along with virtual surgical planning to assess the advantages and the complications in a case of orbital reconstruction. A three-dimensional model of the skull was generated using computed tomography (CT) data of a female patient using Mimics software (version 19, Materialize, Leuven, Belgium). Numerical PSI models were designed using 3-Matic software (version 13, Materialize, Leuven, Belgium) and the non-affected orbit as a template. Surgical virtual planning showed the suitability of the use of the numerical models in traumatic surgical rehabilitation. Moreover, the digital printing process enabled the trial of the designed PSIs on the patient’s face before the surgery. Reconstruction Biomechanical studies are an essential part of understanding the limits of maxillofacial traumas. The surgical results confirmed the virtual predictions, and the orbital reconstruction seems to be more enhanced and facilitated.

The repair and reconstruction of defects in the craniomaxillofacial region can be particularly challenging due to the complex anatomy, individuality of each defect, and sensitivity of the involved systems. This study aims to enhance the facial appearance and contribute to the reconstruction of the zygomatic arch. This was achieved through virtual planning of the surgery and assessment of clinical matching, including orbital measurements and registration of numerical models. A three-dimensional design of a young female case was generated on a skull model using Mimics® software, and the orbit was isolated using 3-Matic® to assess the reconstructive effect. 3D-printed implants were then surgically placed on the injured region, and Netfabb® software was used to make a virtual registration between the numerical models before and after the intervention. This allowed for the calculation of a deviation of 7 mm, equivalent to 86.23% of the shape restoration rate, to assess the success of the surgery. The computerized method enabled a precise design of the needed plates and analysis of the fixation places, resulting in a satisfactory cosmetic and functional outcome for the patient with minimal complications and good implant stability. Notably, a significant difference was observed in the orbital frontal area after 3 months of surgery (p < 0.001). Within the limitations of the study, these results suggest that virtual planning and customized titanium implants can serve as useful tools in the management of complex zygomatic-orbital injuries.

A complex case of maxillofacial trauma that led to a comminuted/fragmented fracture of the orbit-zygomatic complex (OZC) and a globe injury that caused its enucleation.49-year-old women referred from the ambulance department with a story of an injury that resulted in fractures of the lateral and inferior margins and orbital floor, causing loss of the internal dimensions of orbital and facial asymmetry.The case was evaluated and a treatment plan was set based on CT-scan.It was decided to subject the patient to an open reduction, internal fixation of orbital fractures, and orbital exenteration.Then, after the tissue has healed, an artificial eye is replaced.Depending on the precise planning, we were able to reconstruct the orbital shape and volume with titanium plates and mesh based on intact bone pieces.Thus, preparing the orbital socket to receive the artificial eye ball and repair the external contour face shape well.