Sterolithography and Titanium Help Rebuild Wounded Soldiers Jaw

While towing a disabled vehicle through the streets of Bagdad in 2004, Army Staff Sgt. Terry Saffron's HUMVEE was struck by an improvised explosive device. When he came to, he had an injured arm and a shattered jaw.

For years he suffered debilitating jaw pain and was unable to chew. Army doctors worked to repair it but they were unable to get blood flow to the jaw to keep the bone alive.

Sergeant Saffron was referred to Wilford Hall Medical Center here and Maj. (Dr.) Cecelia Schmalbach, chief of head and neck microvascular surgery, for the next steps in his rehabilitation.

One of Dr. Schmalbach's first steps in repairing Sergeant Saffron's jaw was to have a model created of how his jaw should look. She turned to Wilford Hall's stereolithography lab for this.

The lab staff has helped doctors care for patients who have been disfigured by trauma, cancer and congenital anomalies since 1996.

The lab's technicians first used images from CT scans to create a 3-D graphic. They then used 3-D sculpting tools and advanced modeling techniques to produce a mirror image the patient's mandible and created a corrected anatomical jaw. A computer-guided laser used the graphic to create an epoxy photopolymer resin model of how his jaw should look.

"I was able to bend a titanium plate that matched exactly where his old bone was," Dr. Schmalbach said. "I was able to hold a model and look at a film, then look at Sergeant Saffron and try to piece together what was missing, to better anticipate what I would need for his surgery."

With the help of the model created by the stereolithography lab technicians, Dr. Schmalbach was able to successfully use a bone, artery and vein from Sergeant Saffron's leg to repair his jaw. He still has a way to go on his road to recovery but he is able to eat, swallow and talk again.

"There is no question in my mind that I could not have achieved the quality of reconstruction and returning this patient to normal occlusion without the aid of the stereolithography models," said Dr. Schmalbach.

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