Customized Titanium Plates for Preventing Mandibular Fractures in Lower Third Molar Extractions

Area of Science:

• Oral and Maxillofacial Surgery
• Biomedical Engineering
• 3D Printing in Medicine

Background:

• Surgical extraction of impacted lower third molars is complex and carries risks, including mandibular fractures.
• Iatrogenic mandibular fractures can lead to significant patient morbidity and increased healthcare costs.
• Existing methods may not fully mitigate the risk of fractures during these procedures.

Purpose of the Study:

• To evaluate the efficacy of patient-specific 3D-printed titanium plates in preventing intraoperative mandibular fractures during impacted lower third molar extraction.
• To assess the impact of this technique on surgical outcomes, patient safety, and surgeon confidence.

Main Methods:

• Eighteen patients with Pell and Gregory class II/IIIC impacted lower third molars were included.
• Preoperative cone-beam computed tomography (CBCT) scans were used for customized plate and drilling guide design.
• Surgical procedures involved plate placement, osteotomy, odontotomy, extraction, and postoperative assessment of pain, swelling, trismus, and anxiety.

Main Results:

• Customized titanium plates successfully prevented mandibular fractures in all 18 cases.
• Postoperative discomfort (swelling, trismus, pain) was observed but significantly improved within one week.
• No adverse events or fractures were reported, indicating the technique's safety and effectiveness.

Conclusions:

• Customized 3D-printed titanium plates offer a safe and effective solution for reducing mandibular fractures in impacted lower third molar surgery.
• This innovative approach enhances structural reinforcement, improves surgical outcomes, and boosts patient and surgeon confidence.
• The technique represents a promising advancement in minimizing complications associated with complex third molar extractions.