Erol KOZANOĞLU, Bora Edim AKALIN, Ömer BERKÖZ, Soner KARAALİ, Nermin MAMMADOVA, Erman AK, Ahmet Faruk YÜCEL, Ufuk EMEKLİ

ORTOGNATİK MANDİBULA OSTEOTOMİSİNDE YENİ BİR EĞİTİM SEÇENEĞİ: HAVA KURUTMALI KİL MODELİ

Amaç: Hasta güvenliği ve düşük komplikasyon oranları cerrahi eğitimde olmazsa olmazdır ve modeller temel eğitim yöntemleri arasındadır. Bu çalışmanın amacı, ortognatik mandibula osteotomisinde yeni bir modelin etkinliğini değerlendirmektir. Gereç ve Yöntemler: Hava kurutmalı kilden bir şablon ve 17 kısmi mandibula modeli (MM-17) üretildi. Modellerin boyutları sagittal split ramus osteotomisine (SSRO) uygundu. Model cerrahisi ortognatik cerrahide en az üç yıllık deneyimi olan dört cerrah tarafından yapıldı. Her cerrah dört ayrı modelde çalıştı ve şu değerler kaydedildi: kortikotomi ve SSRO tamamlanma süresi, MM-17 kırığı ve türü, MM-17’nin mandibula ile benzerlik değeri, temsil değeri ve eğitim uygunluk değeri. Bulgular: Maliyet 0,6 Amerikan Doları’ydı. Ortalama kortikotomi süresi 127,75 saniyeydi (110-150). Ortalama korteks direnç benzerliği değeri 8,75’ti (8-10). Ortalama SSRO süresi 288 saniyeydi (205-401). Kırıkların yüzde altmışı dış korteksteydi. Ortalama medulla direnç benzerlik değeri 5 (4-6) ve ortalama mandibula temsil değeri 5,25’ti (4-7). Eğitim uygunluk değeri 8,25’ti (7-10). Sonuç: Hava kurutmalı kil, kemik korteksi ile mekanik benzerlikler göstermektedir ve mandibula modeli üretiminde ilk kez kullanılmıştır. Ayrıca, MM-17 diğer modellerden daha ucuzdur. Kortikotomi ve SSRO tamamlanma süreleri kısadır. Çünkü disseksiyon ve kanama gibi hastaya bağlı etkenler yoktur. SSRO’daki yetersizliklerine rağmen MM-17 ortognatik mandibular kortikotomi eğitiminde çok kullanışlı ve düşük maliyetli bir seçenektir. Yüksek devirli motor kullanımı becerileri klinik uygulama öncesi MM-17 ile edinilebilir.

Anahtar Kelimeler:

Eğitim, hava kurutmalı kil, mandibula, model cerrahisi, ortognatik cerrahi

A NOVEL TRAINING ALTERNATIVE IN ORTHOGNATHIC MANDIBULAR OSTEOTOMY: AIR DRIED CLAY MODEL

Objective: Patient safety and low complication rates are indispensable in surgical training and models are among the main educational tools. The aim of this study is to assess the efficiency of a novel model for orthognathic mandibular osteotomy. Material and Methods: A template and seventeen partial mandibular models (MM-17) were manufactured with air dried clay. The dimensions of the models were feasible for sagittal split ramus osteotomy (SSRO). Model surgery was performed by surgeons with a minimum of three years’ experience in orthognathic surgery. Each surgeon operated four separate models and the following data were recorded: corticotomy and SSRO completion time, MM-17 fracture type, similarity value of MM-17 with native mandible, representation value of MM-17, and the training compatibility value of MM-17. Results: The cost was 0.6 American Dollars. The mean corticotomy time was 126.75 seconds (110-150). Mean cortical resistance similarity value was 8.75 (8-10). The mean SSRO time was 288 seconds (205-401). Sixty percent of the fractures were seen in the outer cortex. The mean medullary resistance similarity value was 5 (4-6) and mean mandibular representation value was 5.25 (4-7). The training compatibility value was 8.25 (7-10). Conclusion: Air dried clay demonstrated mechanical similarities with bone cortex and it was used for mandibular modelling for the first time. MM-17 cost less than other devices. Corticotomy and SSRO completion times were short due to the lack of dissection and bleeding. Despite its drawbacks in SSRO, MM-17 is a versatile and low cost alternative in orthognathic mandibular corticotomy training. High power drill utilization skills may be gained with MM-17 before clinical practice.

Keywords:

Air-dried clay, mandible, model surgery, orthognathic surgery, training,

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