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Updated: Aug 31, 2025
A Postoperative Evaluation Guideline for Computer-Assisted Reconstruction of the Mandible
Published on: January 28, 2020
Mandibular Reconstruction Using Iliac Flap Based on Occlusion-Driven Workflow Transferred by Digital Surgical Guides
Yi-Fan Kang1, Meng-Kun Ding1, Shi-Yu Qiu1
1Resident, Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, National Center of Stomatology, Beijing, China, National Clinical Research Center for Oral Diseases, Beijing, China, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, China, Beijing Key Laboratory of Digital Stomatology, Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health, Beijing, China, National Medical Products Administration (NMPA) Key Laboratory for Dental Materials, Beijing, China.
An occlusion-driven workflow for mandibular reconstruction using iliac flaps and digital surgical guides resulted in higher dental implant success rates and improved jaw alignment compared to traditional contour-based methods.
Area of Science:
- Oral and Maxillofacial Surgery
- Biomedical Engineering
- Reconstructive Surgery
Background:
- Mandibular reconstruction traditionally uses fibular flaps, offering good aesthetics but posing challenges for dental implant integration.
- Iliac flaps are more suitable for dental implant placement and occlusion-driven reconstruction.
- Digital surgical guides offer precision in transferring virtual surgical plans to operative procedures.
Purpose of the Study:
- To describe an occlusion-driven workflow for mandibular reconstruction utilizing iliac flaps and digital surgical guides.
- To compare the outcomes of this novel workflow against conventional contour-based reconstruction methods.
Main Methods:
- A retrospective cohort study compared 24 patients undergoing mandibular reconstruction with iliac flaps.
- Patients were divided into occlusion-driven (n=13) and contour-driven (n=11) groups.
- Outcomes assessed included intermaxillary distance, intermaxillary angle, surface deviation, and implantation rates.
Main Results:
- The occlusion-driven group showed a significantly higher implantation rate (61.5% vs. 18.2%, P=.047).
- Greater average acceptable intermaxillary distance was observed in the occlusion-driven group (92.3% vs. 47.0%, P=.01).
- Superior intermaxillary angle correction was achieved with the occlusion-driven approach (88.2° vs. 76.4°, P<.01).
Conclusions:
- Digital surgical guides facilitate accurate virtual-to-real surgical translation in mandibular reconstruction.
- The occlusion-driven workflow demonstrates potential for superior intermaxillary jaw relationships and improved mastication compared to contour-driven methods.
