Outcome Evaluation of Three-Dimensionally Printed Patient-Specific Surgical Plates for Mandibular Reconstruction

Abstract

Study Design

Prospective and retrospective studies.

Objective

The aim of this study was to evaluate the clinical effects and accuracy of three-dimensionally (3D)-printed patient-specific surgical plates used for mandibular defect reconstruction.

Methods

This study included patients who underwent mandibular defect reconstruction with vascularized autogenous bone grafts between January 2012 and August 2021. They were divided into experimental (fixation with 3D-printed surgical plates) and control (fixation with conventional surgical plates) groups. Flap survival rate, postoperative complications and patient self-evaluated facial appearance were compared. Mandibular reconstruction accuracy evaluation included postoperative position deviation of the whole mandible, transplanted bone graft, lower mandibular border, mandibular condyle, and mandibular angle on the reconstructed side compared to baseline.

Results

This study included 20 patients (14 males, six females; age, 39.45 ± 11.69 years), ten each in the experimental and control groups. The mean follow-up was 16 ± 22.05 (range, 6-99) months. All procedures were successful, no plate-related complications (breakage, loosening, or exposure of the surgical plates) were reported, and all patients were satisfied. The groups were statistically similar in th e position deviation of the whole mandible, transplanted bone graft, mandibular condyle, and mandibular angle, but the position and morphology of the lower mandibular border on the reconstructed side in the experimental group were better than those in the control group (P = 0.016).

Conclusions

3D-printed patient-specific surgical plates could be applied in mandibular reconstruction safely and effectively, simplifying the surgical procedure, shortening the preoperative preparation times, achieving satisfactory outcomes, and improving the clinical effects and accuracy of individualized mandibular reconstruction.

Keywords

three-dimensional (3D) printing surgical plate mandibular defect mandibular reconstruction free flap

Get full access to this article

View all access options for this article.

References

Azuma

Yanagawa

Ishibashi-Kanno

, et al. Mandibular reconstruction using plates prebent to fit rapid prototyping 3-dimensional printing models ameliorates contour deformity. Head Face Med. 2014;10:45. doi:10.1186/1746-160X-10-45

Zhang

Wang

, et al. Improving the accuracy of mandibular reconstruction with vascularized iliac crest flap: role of computer-assisted techniques. J Cranio-Maxillofacial Surg. 2016;44(11):1819-1827. doi:10.1016/j.jcms.2016.08.014

Zhang

Liu

Guo

Peng

. Three-dimensional accuracy of virtual planning and surgical navigation for mandibular reconstruction with free fibula flap. J Oral Maxillofac Surg. 2016;74(7):1503.e1-1503.e10. doi:10.1016/j.joms.2016.02.020

Cohen

Laviv

Berman

Nashef

Abu-Tair

. Mandibular reconstruction using stereolithographic 3-dimensional printing modeling technology. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009;108(5):661-666. doi:10.1016/j.tripleo.2009.05.023

Shibahara

Noma

Furuya

Takaki

. Fracture of mandibular reconstruction plates used after tumor resection. J Oral Maxillofac Surg. 2002;60(2):182-185. doi:10.1053/joms.2002.29817

Rana

Chin

Muecke

, et al. Increasing the accuracy of mandibular reconstruction with free fibula flaps using functionalized selective laser-melted patient-specific implants: a retrospective multicenter analysis. J Cranio-Maxillofacial Surg. 2017;45(8):1212-1219. doi:10.1016/j.jcms.2017.04.003

Yang

WFA

Choi

Leung

, et al. Three-dimensional printing of patient-specific surgical plates in head and neck reconstruction: a prospective pilot study. Oral Oncol. 2018;78(November 2017):31-36. doi:10.1016/j.oraloncology.2018.01.005

Yan

, et al. A systematic approach for making 3D-printed patient-specific implants for craniomaxillofacial reconstruction. Eng Times. 2020;6(11):1291-1301. doi:10.1016/j.eng.2020.02.019

Wang

Bai

Han

Zhang

Peng

. Mechanical properties of three-dimensionally printed titanium plates used in jaw reconstruction: preliminary study. Int J Oral Maxillofac Surg. 2022;51(6):754-761. doi:10.1016/j.ijom.2021.09.008

10.

Antony

Chen

Kolokythas

Weimer

Cohen

. Use of virtual surgery and stereolithography-guided osteotomy for mandibular reconstruction with the free fibula. Plast Reconstr Surg. 2011;128(5):1080-1084. doi:10.1097/PRS.0b013e31822b6723

11.

Shao

Liu

. Recent advance in patient-specific 3D printing templates in mandibular reconstruction. J Mech Behav Biomed Mater. 2020;106:103725. doi:10.1016/j.jmbbm.2020.103725

12.

Ghai

Sharma

Jain

Satpathy

Pillai

. Use of 3-D printing technologies in craniomaxillofacial surgery: a review. Oral Maxillofac Surg. 2018;22(3):249-259. doi:10.1007/s10006-018-0704-z

13.

Khorsandi

Fahimipour

Abasian

, et al.. 3D and 4D printing in dentistry and maxillofacial surgery: recent advances and future perspectives. Acta Biomater 2021;1122:26-49. doi:10.1016/j.actbio.2020.12.044

14.

Smith

Schrag

Chandarana

, et al. Novel plate design to improve mandibular and maxillary reconstruction with the osteocutaneous fibula flap. Plast Reconstr Surg - Glob Open. 2019;7(1):1-4. doi:10.1097/GOX.0000000000002094

15.

Nickels

. World’s first patient-specific jaw implant. Met Powder Rep. 2012;67(2):12-14. doi:10.1016/S0026-0657(12)70128-5

16.

Yang

Choi

Wong

MCM

, et al. Three-dimensionally printed patient-specific surgical plates increase accuracy of oncologic head and neck reconstruction versus conventional surgical plates: a comparative study. Ann Surg Oncol. 2021;28(1):363-375. doi:10.1245/s10434-020-08732-y

Supplementary Material

Please find the following supplemental material available below.

For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.

For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.

0.00 MB

0.32 MB