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Updated: Apr 15, 2026
A Postoperative Evaluation Guideline for Computer-Assisted Reconstruction of the Mandible
Published on: January 28, 2020
Comparison of intraoperative time measurements between osseous reconstructions with free fibula flaps applying
Jan Rustemeyer1, Aynur Sari-Rieger, Alex Melenberg
1Department of Oral and Maxillofacial Surgery, Plastic Operations, Klinikum Bremen-Mitte, School of Medicine, University of Göttingen, Bremen, Germany, janrustem@gmx.de.
Purpose:
We aimed to determine whether computer-aided designed/computer-aided manufactured (CAD/CAM) techniques could save intraoperative time compared with the conventional technique, by comparing flap harvesting and ischemia times, and subsequently impact flap survival.
Methods:
Twenty patients underwent concurrent osteocutaneous fibula flaps, either with (n = 10) or without (n = 10) the CAD/CAM technique. Demographic data, clinical history, complications, number of osseous segments, and times for virtual planning, flap harvesting, flap ischemia, tourniquet inflation, and total reconstruction were recorded.
Results:
There was no significant difference between CAD/CAM and conventional techniques with respect to age, number of osseous segments, complication rates, and tourniquet inflation time. Flap harvesting times were significantly shorter in the conventional group (112.1 vs. 142.2 min, p < 0.001), while flap ischemia and total ischemia times were significantly shorter in the CAD/CAM group (70.7 vs. 98.6 min, p < 0.001; 174.8 vs. 198.9 min, p = 0.002, respectively). However, while total reconstruction time did not differ between groups, overall operating time (including the amount of virtual planning time and surgical reconstruction time) was significantly longer in the CAD/CAM group (mean 256.0 vs. 210.7 min, p < 0.001).
Conclusions:
Despite the advantages of the CAD/CAM technique, including reduced ischemia time of osteocutaneous fibula flaps, there is no impact on total reconstruction time or flap survival.
