Virtual Planning and 3D printing modeling for mandibular reconstruction with fibula free flap

• Wenhao Ren ^[1] ; Ling Gao ^[1] ; Shaoming Li ^[1] ; Cheng Chen ^[3] ; Fan Li ^[1] ; Qibo Wang ^[1] ; Yuan Zhi ^[2] ; Jianzhong Song ^[1] ; Zhichao Dou ^[1] ; Lingfa Xue ^[1] ; Keqian Zhi ^[1]
  1. [1] Affiliated Hospital of Qingdao University

     Affiliated Hospital of Qingdao University

     China

     
  2. [2] Central South University

     Central South University

     China

     
  3. [3] Department of General Dentistry, College of Stomatology, Xi’an Jiaotong University, Xi’an, Shaanxi, P. R. China

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• Localización: Medicina oral, patología oral y cirugía bucal. Ed. inglesa, ISSN-e 1698-6946, Vol. 23, Nº. 3 (May ), 2018
• Idioma: inglés
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• Resumen

  • This study was to evaluate the use of virtual planning and 3D printing modeling in mandibular reconstruction and compare the operation time and surgical outcome of this technique with conventional method.

    Between 2014 and 2017, 15 patients underwent vascularized fibula flap mandibular reconstruction using virtual planning and 3D printing modeling. Titanium plates were pre-bent using the models and cutting guides were used for osteotomies. 15 patients who underwent mandibular reconstruction using fibula flap without aid of virtual planning and 3D printing models were selected as control group. The operation time was recorded and compared in two groups. Accuracy of reconstruction was measured by superimposing the preoperative image onto the postoperative image of mandible. The selected bony landmark, distance and angle were measured.

    The mean total operation time and reconstruction time were 1.60±0.37 and 5.54±0.50 hours in computer-assisted group, respectively; These were 2.58±0.45 and 6.54±0.70 hours in conventional group, respectively. Both operation time and reconstruction time were shorter in computer-assisted group. The difference between the preoperative and postoperative intercondylar distances, intergonial angle distances, anteroposterior distances and gonial angles were 2.92±1.15 and 4.48±1.41mm, 2.93±1.19 and 4.79±1.48mm, 4.31±1.24 and 5.61±1.41mm, 3.85±1.68° and 5.88±2.12° in the computer-assisted and conventional group, respectively. The differences between the preoperative and postoperative mandible is smaller in the computer-assisted group.

    Virtual planning and 3D printing modeling have the potential to increase mandibular reconstruction accuracy and reduce operation time. we believe that this technology for mandibular reconstruction in selected patients will become a used method and improve the quality of reconstruction.