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Updated: Apr 5, 2026
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A Postoperative Evaluation Guideline for Computer-Assisted Reconstruction of the Mandible
Published on: January 28, 2020
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Mandibular reconstruction using fibula free flap harvested using a customised cutting guide: how we do it
A Tarsitano1, L Ciocca2, R Cipriani3
1Maxillofacial Surgery Unit, Policlinico "S. Orsola-Malpighi", University of Bologna, Italy;
Summary
Customized cutting guides improve fibula flap reconstructions for mandible defects. This technique enhances the accuracy of recreating the mandible's original 3D shape, leading to better aesthetic and functional outcomes after cancer surgery.
Area of Science:
- Oral and Maxillofacial Surgery
- Biomedical Engineering
- Plastic and Reconstructive Surgery
Background:
- Free fibula flap is a standard for mandibular reconstruction.
- Manual bending of plates complicates precise 3D contouring, risking aesthetic and functional deficits.
- Achieving native mandibular morphology is challenging with current methods.
Purpose of the Study:
- To evaluate the efficacy of customized CAD-CAM fibular cutting guides for mandibular reconstruction.
- To improve morphological and functional outcomes in patients undergoing oncological segmental resection.
Main Methods:
- Customized fibular cutting guides were designed using CAD-CAM technology.
- Guides were used for precise osteotomies in free fibula flaps.
- Reconstructions were performed in 20 patients undergoing oncological mandibular resection.
Main Results:
- The study demonstrated the successful application of customized cutting guides.
- This method facilitated more accurate reproduction of the native mandibular 3D conformation.
- Improved aesthetic and functional results were observed post-reconstruction.
Conclusions:
- CAD-CAM customized fibular cutting guides offer a superior approach to mandibular reconstruction.
- This technique enhances precision, potentially reducing malocclusion and temporomandibular disorders.
- Customized guides represent a significant advancement in achieving patient-specific reconstructions.
