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Updated: Jul 17, 2025
A Postoperative Evaluation Guideline for Computer-Assisted Reconstruction of the Mandible
Published on: January 28, 2020
How Is a Cutting Guide With Additional Anatomical References Better in Fibular-Free Flap Mandibular Reconstruction? A
Nutcha Yodrabum1, Jirapat Tianrungroj1, Chanya Sinmaroeng1
1Department of Surgery, Division of Plastic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University.
Background:
Computer-assisted surgery is used to design and manufacture cutting guides in mandibular reconstructions with fibula-free flaps. To improve the outcomes of the procedure, the aim of this research was to investigate and compare the accuracy of mandibular reconstruction following the use of 2 versus 3 anatomical reference cutting guides.
Methods:
Eighteen sets of prototype bone models retrieved from an ameloblastoma patient were used for mock operations. The mandibular segmental osteotomies and fibular reconstructions were performed using 2 and 3 anatomical reference cutting guides in vivo surgeries. After reconstruction, the accuracy of the placed reference points was measured by superimposition of computed tomography images.
Results:
The error in cutting guides when using 2 or 3 anatomical references showed no significant difference. The fibular and condylar errors of the cutting guide between 2 and 3 anatomical references showed no significant difference in every plate type. The difference in screw hole position errors between 2 and 3 anatomical reference cutting guides was not statistically significant.
Conclusions:
Two anatomical reference cutting guides are sufficient and reasonable enough for mandible resection. However, there were some limitations and errors in our study.
