Efficacy of Custom-Made Appliance by the Method of CAD/CAM Compared with Conventional Dressing for Reducing Facial Swelling after Maxillofacial Surgery

 Swelling of the surrounding tissue of surgical site is one of the most common, devastating effects after maxillofacial surgery and can have an effect on quality of life and the patients' satisfaction.

The purpose of this study was to investigate the effect of a custom-made appliance by the method of Computer-aided design/Computer-aided manufacturing (CAD/CAM) compared with conventional dressing for reducing facial swelling after maxillofacial surgery. 

This clinical trial accomplished in 14 patients voluntarily referred to the Department of Oral and Maxillofacial Surgery at Bahonar hospital in Kerman. These patients were the candidate for surgical treatment of similar bilateral facial fractures (10 patients) and orthognathic surgery (4 patients). Facial computed tomography (CT) scans of the patients were taken to build up a custom-made appliance. Based on three-dimensional reconstruction from facial CT scan data, custom-made appliance was designed and built. Swelling on one side with custom-made appliance and on the opposite side with conventional dressing measured with paper tape graded before surgery, immediately after surgery, 24 hours, 48 hours, and 7 days later, we divided the patients into two groups of trauma and orthognathic surgical procedures

Based on the defined landmarks, all of the measurements were performed on both sides. Statistical analyses do not show any asymmetry before surgery (p= 0.48). In addition, there was no significant difference between two methods of dressing on the day of surgery and a day later (p= 0.084, p= 0.09), but there was a significant difference between two methods of dressing on second and seventh days. The swelling has decreased faster and further in our new method.

Regarding the exact adaptation to the surgical site on facial skin, using custom-made appliance by the method of CAD/CAM could be an effective tool that reduces swelling after maxillofacial surgery.