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Updated: Jun 30, 2026
08:01
Designing CAD/CAM Surgical Guides for Maxillary Reconstruction Using an In-house Approach
Published on: August 24, 2018
9.4K
Computer Aided Design/Computer Aided Manufacturing-Guided Scapular Tip Free Flap Reconstruction for Complex
Francesco Laganà1, Alice Marzi Manfroni1, Francesco Arcuri1
1Maxillofacial Surgery Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
Microsurgery
|January 10, 2026
Summary
Computer-Aided Design and Manufacturing (CAD/CAM) with scapular tip free flaps (STFF) improves complex maxillofacial reconstructions. This technique enhances surgical precision, reduces operative times, and leads to predictable functional and aesthetic outcomes for patients.
Area of Science:
- Oral and Maxillofacial Surgery
- Plastic Surgery
- Biomedical Engineering
Background:
- Reconstructing complex maxillary and mandibular defects after cancer surgery presents significant challenges.
- The scapular tip free flap (STFF) offers a viable solution due to its vascularity and bone stock.
- Computer-Aided Design and Manufacturing (CAD/CAM) can optimize reconstructive surgery, but its application in STFF for supine harvesting and inset is novel.
Purpose of the Study:
- To evaluate the advantages of using CAD/CAM technology to guide resection and reconstruction in complex maxillary and mandibular defects using STFF.
- To assess the impact of CAD/CAM-assisted STFF on operative efficiency, functional recovery, and aesthetic outcomes.
Main Methods:
- A retrospective analysis of nine patients who underwent maxillary or mandibular reconstruction with STFF between January 2023 and December 2024.
- Preoperative virtual surgical planning using CAD/CAM for patient-specific guides and plates.
- Assessment of functional outcomes (EORTC QLQ-HN35), morphological accuracy (3D imaging overlay), operative/ischemia times, complications, and patient satisfaction.
Main Results:
- All reconstructions were successful with no major intraoperative complications.
- CAD/CAM planning facilitated precise osteotomies and flap contouring, reducing ischemia time and improving workflow, especially in mandibular cases.
- High concordance between pre- and postoperative imaging demonstrated satisfactory restoration of facial contour, with high patient satisfaction.
Conclusions:
- CAD/CAM-assisted STFF reconstruction enables accurate 3D restoration, shortening operative and ischemia times.
- This approach leads to predictable functional recovery and favorable aesthetic results in complex maxillofacial defects.
- Despite increased planning, CAD/CAM enhances efficiency and reproducibility, offering a valuable option for selected patients.
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