Comparison of customized plate navigation and traditional methods in mandibular reconstruction: enhanced accuracy and...

This randomized controlled trial evaluated the three-dimensional (3D) accuracy of condylar positioning in mandibular reconstruction using pre-bent plates with customized plate navigation (CPN) compared with the traditional method (TM). Thirty patients with mandibular tumours were randomized to the CPN or TM group (15 each). Pre- and postoperative computed tomography quantified deviations in intercondylar distance and angulation, 3D displacement of the most superior point (assessed in superior-inferior, anterior-posterior, and medial-lateral directions on the affected condyle), and affected condylar axis orientation (coronal, sagittal, transverse). Overall 3D condylar deviation and total operative time (TOT) were also compared. The CPN group showed smaller deviations than the TM group in intercondylar distance (P = 0.031) and angulation (P = 0.023), and in anterior-posterior (P = 0.041) and medial-lateral (P = 0.046) displacement. Condylar axis alignment was improved in the CPN group in the coronal (P < 0.001), sagittal (P < 0.001), and transverse (P = 0.001) planes. Overall 3D condylar deviation on the affected side was smaller with CPN for physiological (P = 0.019) and absolute (P = 0.039) registrations. TOT was shorter with CPN (P < 0.001). Thus, CPN improves surgical precision and efficiency in mandibular reconstruction.