Clinical application of virtual surgery and 3D-printed plates in reconstruction of mandibular defects with fibula myocutaneous flap

Abstract:

Objective：To achieve accurate individualized reconstruction of mandibular defects with fibula myocutaneous flap based on virtual surgery and 3D-printed plates，and to explore the role of 3D-printed plates in improving the reconstructive accuracy of mandibular defects. Methods：The resection of mandibular lesions and reconstruction of fibular graft in 10 patients was performed using computer simulation before surgery. The 3D-printed plates were designed and produced in reconstruction of mandible during surgery. The difference between practical and simulative operations was determined using image fusion technology after surgery and the differ－ence values were analyzed statistically. Results：The 3D-printed plates were successfully implanted. The features and occlusal relationship of patients were well recovered. The measurements showed that the maximum margin of error between practical and sim－ulative osteotomy was （1.57±0.80） mm. Conclusion：The ap－plication of digital 3D-printed plates ensure a high accuracy in reconstruction of mandibular defects with fibula myocutaneous flap. The application of condylar positioning plates in fixing residual mandible effectively stabilized condylar position on the affected side and improved the reconstructive accuracy.