Patient-specific reconstruction plates are the missing link in computer-assisted mandibular reconstruction: A...

Area of Science:

• Oral and Maxillofacial Surgery
• Biomedical Engineering
• Digital Dentistry

Background:

• Virtual surgical planning (VSP) and CAD/CAM technologies have advanced mandibular reconstruction.
• Current methods often rely on prebent plates, introducing analogue steps and limiting digital workflow accuracy.
• Patient-specific instrumentation is crucial for optimizing digital workflows in complex reconstructions.

Observation:

• This study demonstrates the clinical integration of computer-controlled, numerically-controlled (CNC) milled patient-specific mandibular plates (PSMP) in a virtual workflow.
• The PSMP were utilized in computer-assisted mandibular free fibula flap reconstruction.
• Intraoperative assessment revealed excellent fit of bone segments and plate arms.

Findings:

• Postoperative CT scans confirmed precise approximation of the PSMP and fibular segments.
• Good alignment was achieved between native mandible and fibular segments, as well as intersegmentally.
• A 12-month follow-up showed uneventful healing with robust bony consolidation.

Implications:

• Automated fabrication of patient-specific mandibular plates bridges the gap in the virtual workflow for computer-assisted reconstruction.
• This approach enhances the precision and efficiency of mandibular free fibula flap reconstruction.
• The digital integration of PSMP represents a significant advancement in reconstructive surgery planning and execution.