CMF Update

Task Force work and approaches to evaluate new technologies

The AO Technical Commission Craniomaxillofacial (AO TC CMF) has gone through a remarkable change in structure and strategy. The former Expert Groups have been dissolved to focus on specific task and projects in new task forces for more flexibility and less overlap among the groups working in the area on new solutions. In 2020 the AO TC CMF established two task forces and initiated two initiatives to evaluate further technologies to set the base for future projects.


Patient Specific Solutions Task Force

The CMF area has been the front-runner in digitalizing planning in fracture and deformity treatment and the first area where the use of patient specific implants and guides has become not only an option but also in some indications the state-of-the art treatment. As with all new technologies the first years involve a lot of enthusiasm and learning by doing, it has become obvious that certain principles and rules in patient care still need to be followed. Therefore, the AO TC CMF initiated the collection of clinical data in specific areas where patient specific implants are mostly used. In AO TC CMF Workshops and the first CMF Symposium the AO TC CMF together with key opinion leaders in the field elaborated on specific workflows with common standards for the clinical image-based planning of the treatment, the design of the implants and guides and the planning of the surgical procedure with the patient specific instrumentation. The newly established Patient Specific Solutions Task Force is now in charge to further develop and harmonize the workflows with providing basic principles for the imaging and clinical analysis for specific indications, establishing rules for the planning and design of the patient specific implants for those indications and the adapted surgical procedures where applicable. The goal is to provide information and guidance to help surgeons to safely start using this technology and acquire experience without the difficulty of making avoidable mistakes.

CMF Distraction Task Force

The CMF Distraction Task Force was established to support the introduction of the new CMF Distractor into the market and collect clinical data to provide clinical evidence for this new tool as well as for distraction procedures in the CMF area in general. Further development in patient specific planning and the use of patient specific footplates for the distractors is the next step in development. The evaluation of enhanced technologies for distraction control and the collection of feedback about the distraction forces and the established bone formation for the further development of new solutions are long-term goals of this task force.


Initiatives to evaluate new technologies

The AO TC CMF invited a small company to present its solution for TMJ Replacement based on patient specific implants to evaluate this technology. As the introduction of new devices in TMJ Replacement is strongly regulated by the US Food and Drug Administration and its Medical Device Reporting surveillance tool, the development of new solutions has to overcome major hurdles, which makes the development from scratch a difficult and risky journey. Consequently, the AO TC CMF decided to evaluate further solutions and compatible partners experienced in TMJ Replacement for a collaboration in this field. A second interesting new technology is the use of patient specific graft cages for bridging critical gaps in bony structures because of bone loss after ablative surgery or trauma. The AO TC CMF supports a sheep study to prove the concept of using patient specific graft cages in the mandible to regain bony structures, which will be able to close the gap and support the fixation of dental implants to recover full function.

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