Enhanced accuracy of cutting planes and condylar positioning in mandibular reconstruction using...

Accurate mandibular reconstruction, particularly condylar repositioning, is essential for restoring function and facial symmetry following segmental resection. This study aimed to evaluate the accuracy of cutting planes and three-dimensional (3D) condylar positioning using 3D-printed cutting guides combined with plate-guided positioning.

This in vitro study included sixteen 3D-printed mandibular models simulating segmental defects. Virtual surgical planning was employed to fabricate 3D-printed cutting guides and plate-guided positioning. Postoperative models were compared with their corresponding virtual models using 3-Matic software to assess cutting plane and 3D condylar positioning deviations.

The angular deviations of the proximal cutting plane averaged 13.27 ± 10.36 mm in pitch and 12.1 ± 8.67 mm in yaw, demonstrating acceptable alignment. The mean difference in defect distance was 0.51 ± 3.53 mm (P = 0.93). Intercondylar angulation deviation was 2.13 ± 2.53°, with no significant difference in intercondylar distance (100.75 ± 7.32 mm vs. 102.01 ± 6.99 mm, P = 0.51). On the operative side, deviations of the highest points of the condyle were 2.76 ± 3.39 mm (superior-inferior), 2.37 ± 2.76 mm (anterior-posterior), and 1.94 ± 2.93 mm (medial-lateral). Angular deviations of the condylar head axis were minimal in the coronal (1.66 ± 1.38°) and transverse (1.52 ± 1.51°) planes, as opposed to the sagittal plane (5.61 ± 5.26°).

3D-printed cutting guides and plate-guided positioning allowed for accurate replication of virtual surgical plans in mandibular reconstruction. All deviations remained within acceptable limits. Further research is recommended to validate these findings.