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Updated: Jun 18, 2026
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A Postoperative Evaluation Guideline for Computer-Assisted Reconstruction of the Mandible
Published on: January 28, 2020
Accuracy and Clinical Outcomes of Mandibular Reconstruction Using Fibula Free Flaps and Open-Source Virtual Surgical
Dung Thi Vu1, Quang Duy Thai2,1, Viet-Dung Thi Pham2
1Department of Microsurgery, Plastic, Aesthetic and Maxillofacial Surgery, Hanoi Medical University Hospital.
The Journal of Craniofacial Surgery
|June 17, 2026
Summary
Open-source virtual surgical planning and 3D-printed models enable accurate fibula free flap mandibular reconstruction. This cost-effective method achieved excellent clinical outcomes without cutting guides, even in resource-limited settings.
Area of Science:
- Oral and Maxillofacial Surgery
- Biomedical Engineering
- 3D Printing Applications
Background:
- Mandibular reconstruction with fibula free flaps (FFF) is standard but achieving anatomical precision is difficult with freehand techniques.
- Virtual surgical planning (VSP) and 3D printing offer potential solutions for complex reconstructions.
Purpose of the Study:
- To evaluate the surgical accuracy and clinical outcomes of mandibular reconstruction using open-source VSP and 3D-printed models without cutting guides.
- To assess the feasibility and cost-effectiveness of this approach.
Main Methods:
- Twenty-five patients underwent FFF reconstruction with preoperative open-source VSP (3D Slicer, Blender).
- 3D-printed models served as intraoperative guides; osteotomies were performed freehand.
- Surgical accuracy was measured by comparing preoperative plans to postoperative CT scans.
Main Results:
- Linear deviations between planned and actual outcomes ranged from 1.53 to 3.05 mm, considered clinically acceptable.
- High concordance was observed, with minor statistically significant differences in some measurements (P<0.05).
- Flap survival was 100%, with stable occlusion, symmetry, function, and only one minor complication.
Conclusions:
- Open-source VSP and 3D printing provide accurate, reliable, and cost-effective mandibular reconstruction.
- This technique is feasible and effective, even without intraoperative cutting guides.
- It is a particularly valuable approach for resource-limited settings.
