[Clinical application and accuracy analysis of occlusion-guided functional mandibular reconstruction]

Area of Science:

• Oral and Maxillofacial Surgery
• Biomedical Engineering
• Reconstructive Surgery

Background:

• Segmental mandible defects pose challenges for functional and aesthetic reconstruction.
• Accurate placement of implants is crucial for successful implant-supported prosthetics.
• Occlusion-guided reconstruction requires precise surgical planning and execution.

Purpose of the Study:

• To evaluate the efficacy of a novel surgical template in improving the accuracy of mandible reconstruction.
• To assess the precision of implant positioning within the reconstructed mandible.
• To guide clinical practice in occlusion-guided functional mandibular reconstruction.

Main Methods:

• 11 patients with segmental mandible defects underwent reconstruction using a novel surgical template.
• The template incorporated reconstruction plate screws and implant drill guidance.
• Postoperative CT scans analyzed the coincidence of the reconstructed mandible and implant positions.
• Osseointegration was assessed via radiography and CBCT at 6 months.

Main Results:

• High coincidence rates were observed for the fibular upper barrel (87.55%±3.08%) and the whole mandible (82.68%±5.94%).
• Implant positioning accuracy in the mandible was 88.00%.
• All 22 implants achieved osseointegration, enabling successful denture rehabilitation and high patient satisfaction.

Conclusions:

• The novel surgical template effectively guides occlusal reconstruction, ensuring accurate mandible and implant positioning.
• This approach achieves aesthetically pleasing results and restores occlusal function.
• The method significantly improves patients' quality of life post-reconstruction.