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A Postoperative Evaluation Guideline for Computer-Assisted Reconstruction of the Mandible

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Oncological Outcomes Following Computer-Aided Reconstructive Jaw Surgery.

John M Le¹, John Hofheins¹, Myra Rana²

¹Department of Oral and Maxillofacial Surgery, University of Alabama at Birmingham, Birmingham, AL 35233, USA; jhofheins@uabmc.edu (J.H.); jponto@uabmc.edu (J.P.); morlandt@uab.edu (A.B.M.); yying@uab.edu (Y.P.Y.).

Craniomaxillofacial Trauma & Reconstruction

|April 24, 2025

Summary

Computer-aided surgical planning (CAS) in jaw cancer reconstruction did not improve bone margin status or reduce local recurrence. This retrospective analysis found no significant difference in outcomes between CAS and traditional methods for oncological reconstructive surgery.

Keywords:

local recurrence oral cancer oral oncology reconstructive surgery virtual surgery

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Area of Science:

Oral and Maxillofacial Surgery
Surgical Oncology
Medical Technology

Background:

Oncological reconstructive surgery of the jaws presents challenges in achieving clear surgical margins.
Computer-aided surgical planning (CAS) is increasingly utilized, but its impact on oncological outcomes requires evaluation.

Purpose of the Study:

To analyze the association between computer-aided surgical planning (CAS) and histopathological bone margin status in patients undergoing oncological reconstructive jaw surgery.
To evaluate the impact of CAS on local recurrence and disease-free survival (DFS) in this patient population.

Main Methods:

Retrospective analysis of patients who underwent microvascular reconstructive surgery between 2014 and 2021.
Comparison of outcomes between a group utilizing CAS and a control group without CAS.
Statistical analysis of demographic, operative, pathological, and clinical data, focusing on margin status, local recurrence, and DFS.

Main Results:

Thirty-five patients in the CAS group and fifty-two in the non-CAS group were analyzed; demographic characteristics were comparable.
The osteocutaneous radial forearm flap was more common in the non-CAS group (34.6% vs. 2.9%).
CAS was not significantly associated with improved bone margin status (p=0.65), reduced local recurrence (p=0.08), or comparable DFS (p=0.74).

Conclusions:

The use of CAS in oncological reconstructive jaw surgery was not associated with improved bone margin involvement.
Current evidence does not support a significant benefit of CAS regarding margin status or recurrence in this specific surgical context.