Computer-Assisted Mandibular Reconstruction with a Single-Step Free Fibula Flap and Simultaneous Implant Placement

The free fibula flap is a reliable approach used to reconstruct maxillofacial osseous defects. Virtual surgical planning facilitates the execution of such segmental bony reconstruction, usually preceding the placement of endosseous implants for dental rehabilitation. Novel advances in digital technology allow for fabrication of 3D guides for implant placement in the fibula bone segments before their fixation to the facial defect, with reduced ischemic time, reduced treatment time, faster dental rehabilitations, and unprecedented improvements in the overall treatment efficiency. This case report illustrates the use of digitally designed 3D-printed surgical plates for a single-stage surgery of free fibula flap with implant placement. The patient was successfully treated and followed over 2 years. Comparison between preoperative virtual planning and postoperative scans revealed a high accuracy of implant and bone segment positioning.