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Outcomes of Mandible Reconstruction Using Surgeon-Specific, Patient-Specific, and Conventional Plates
Nina Patel1, Autefeh Sajjadi1, Andrea Park1
1Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology - Head and Neck Surgery, University of California, San Francisco, San Francisco, California, USA.
The Laryngoscope
|June 19, 2026
Summary
For microvascular mandibular reconstruction, surgeon-specific plates (SSPs), patient-specific plates (PSPs), and conventional plates (CPs) show similar clinical and radiographic outcomes. Plate choice depends on surgeon preference and reconstruction complexity.
Area of Science:
- Oral and Maxillofacial Surgery
- Plastic Surgery
- Reconstructive Surgery
Background:
- Mandibular reconstruction is crucial for restoring function and aesthetics after trauma or cancer resection.
- Plate selection impacts surgical outcomes, including union rates and complications.
- Comparing surgeon-specific plates (SSPs), patient-specific plates (PSPs), and conventional plates (CPs) is essential for optimizing reconstruction techniques.
Purpose of the Study:
- To compare operative metrics, postoperative complications, and radiographic osseous union among SSPs, PSPs, and CPs in microvascular mandibular reconstruction.
- To identify factors associated with nonunion in mandibular free flap reconstructions.
Main Methods:
- Retrospective review of 171 patients undergoing mandibular free flap reconstruction (2020-2025).
- Stratification by plating technique: SSP (n=52), PSP with CAD/CAM (n=58), and CP (n=61).
- Analysis of operative time, hospital stay, complications, osteotomy characteristics, and CT-based osseous union.
Main Results:
- Operative time, hospital stay, and ischemia time did not differ significantly between plating methods.
- Postoperative complication rates were low and similar across groups (infection, hematoma, reoperation).
- Radiographic nonunion and time-to-Grade 2 union were comparable across all plating strategies; nonunion associated with postoperative complications.
Conclusions:
- Microvascular mandibular reconstruction yields comparable clinical and radiographic outcomes irrespective of the chosen plate type.
- Plate selection and computer-aided design/manufacture (CAD/CAM) utilization should be guided by surgeon preference and the complexity of the reconstruction.
