ORIGINAL ARTICLE   

European Journal of Oral and Maxillofacial Surgery 2020 April;4(1):1-7

DOI: 10.23736/S2532-3466.19.00187-5

Copyright © 2019 EDIZIONI MINERVA MEDICA

language: English

Outcomes of using pre-bent reconstruction plates in mandibular reconstruction

Sabah A. ISSA, Hussein A. ABDULNABI ✉

Department of Oral and Maxillofacial Surgery, Medical City Complex, Baghdad, Iraq

BACKGROUND: The advances in computer aided design (CAD) and rapid prototyping techniques have been applied in mandibular reconstruction procedures to improve the outcomes and decrease the complications. We described the use of CAD techniques, and medical rapid prototyping (MRP) models for preoperative contouring of the reconstruction plates. The outcomes of mandibular contour symmetry and the efficacy of the technique were evaluated.
METHODS: Fourteen patients with lateral discontinuity defect after ablative resection of benign and malignant tumors underwent mandibular reconstruction, using preoperatively contoured reconstruction plates, adapted on MRP models that were designed in CAD planning software and fabricated by fused deposition modelling three-dimensional printer. The surgical time needed for positioning and fixation of the pre-bent plate was recorded, and the value of mandibular angle was measured on both sides using panoramic radiography.
RESULTS: The median time that was elapsed in positioning and fixation of the pre-bent reconstruction plate was 9 minutes ranging from 4 minutes to 35 minutes. Postoperatively, there was insignificant statistical difference in the value of both mandibular angles on the two sides of the mandible (P=0.298).
CONCLUSIONS: The use of virtual planning and MRP models for preoperative bending of the reconstruction plates helps in achieving improved esthetic outcomes. However, some limiting aspects exist mainly regarding the manual plate transfer and positioning. Further proposed measures for guiding the bone resection and the pre-bent plate positioning may need consideration in specific cases.

KEY WORDS: Bone plates; Surgery; Mandibular reconstruction