Exenteration of the eye is one of the most aggressive surgical approaches, which is usually seen after orbital tumor resection. Acquired defects of the orbital location can be seen due to tumors and trauma, while congenital defects appear as the result of developmental anomalies.
Orbital defects can arise from acquired or congenital anomalies. The studies concluded that the digital planning, designing and fabrication of orbital prostheses reduce the clinical and laboratory times, reduces patient visits and provide a satisfactory outcome however, technical skills and equipment costs are posing limitations on the use of these digital systems. Digital designing and printing systems were reported for the preoperative planning of craniofacial implants placement, designing of molds and substructures and fabrication of orbital prostheses. An image-guided surgical navigation system was utilized for the placement of five orbital implants in two cases. Surgical templates were fabricated for 12 cases to place 41 craniofacial implants in the orbital defect area.
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Meanwhile, the digital designing software were Ease Orbital Implant Planning EOIPlan software in eight cases, Geomagic software in eight cases, Simplant software in four cases and Artec Studio 12 Professional in three cases. The most common preoperative data required for digital planning were CT scans in 15 cases, the 3DSS-STD-II scanning system in 5 cases, an Artec Color 3D scanner in 3 cases and a NextEngine Desktop 3D laser scanner in 2 cases. A total of 16 studies of 30 clinical cases, which were virtually planned through various digital planning and designing software, were included. Human studies that utilized digital planning systems for the prosthetic rehabilitation of orbital defects were included. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, an electronic search was executed.
This systematic review was aimed at gathering technical and clinical applications of CAD/CAM technology for the preoperative planning of craniofacial implants placement, designing of molds and substructures and fabrication of orbital prostheses.