The mean error across the PPA predictive holes and corresponding holes of the prebent plates was −0.194 mm ( P < .001, general estimating equation regression). The mean error between the body (−0.265) and condylar segments (−0.116 mm) and mean difference in error between the proximal predictive holes (−0.124 mm) and distal predictive holes (−0.215 mm) on the PPA were not statistically different ( P = .061, P = .314 general estimating equation regression, respectively). The median distance from the points of reference in the PPA versus the prebent plate was calculated for each predictive hole position in addition to the average error of the PPA to the stock plate.Įighteen PPAs were used for statistical analysis 2 were damaged in transport. The proximal and distal 4 holes of each prebent plate and corresponding PPA were assessed using a heat map overlay, measuring difference in millimeters between matching points of the predictive hole segments. Twenty stock 2.0 reconstruction plates prebent against a 3-dimensional printed mandibular model reconstructed with a 2-piece fibula were used to fabricate 20 PPAs. The purpose of this article is to describe an accurate and economical alternative to custom plates, while still having the ability to create predictive holes for plate alignment and execution of a digital surgical plan.Īn in vitro accuracy study was performed on a point-of-care resin-printed predictive hole guide termed “prebent plate analog” (PPA).
Stock plates are more easily accessible and are more economical but typically preclude the utilization of these predictive holes. In computer surgical planned (CSP) fibular reconstructions of the mandible, custom plates facilitate accurate and efficient transfer of the digital plan intraoperatively by a way of predrilled fixation holes. Also, since most patients had concomitant TMJ symptoms, their severity of pain could not be interpreted accurately as we record the global pain intensity and not the score As there is no specific ICD code for FBS, the search likely failed to uncover other patients with this diagnosis, which makes it difficult to interpret the true prevalence of this syndrome. The retrospective nature of the study and small sample size poses limitations and hence the results should be interpreted with caution. Our study documents the highest number of patients reported thus far who developed FBS symptoms after TMJ surgical procedures.
#First bite syndrome cure series#
We document a series of 19 patients with FBS after TMJ surgery and in addition 3 patients with idiopathic FBS, 1 patient with parapharyngeal space tumor and 1 patient with facial burns.
The goal of our study was to identify patients with FBS occurring after TMJ surgery, to describe their pain characteristics, risk factors and treatment outcomes. RPDR identified 164 records (1 with parapharyngeal space tumor and 1 with burn related FBS). The idiopathic FBS diagnosis was determined based on the pain characteristics and absence of clinical or radiologic evidence (established by MRI) of head and neck tumor, negative history for head and neck surgery or trauma. Oral-maxillofacial surgery and OFP, MGH registry identified 22 patients (19 status post TMJ surgery, 3 idiopathic FBS).
Using the latter resource, the following ICD Results
Patients with FBS were identified from patients seen in the oral-maxillofacial surgery and OFP clinics, MGH and from the RPDR of Partners Healthcare which included records from the MGH, Brigham and Woman's Hospital and Massachusetts Eye and Ear Infirmary, between 1975-2019. The study was performed in accordance with the standards of the Declaration of Helsinki and was approved by Partners Institutional Review Board (Protocol #: 2020P001201).
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