A device to improve the efficiency of surgery in patients undergoing mandibular reconstruction by preoperative plate bending and template production

Abstract

For the treatment of head and neck cancer, we have adapted dental techniques to devise novel surgical measures using plaster 3-dimensional (3D) models, and have obtained reasonable results. In the present study, we present some cases involving evaluations of clinical outcomes. The subjects comprised two patients who underwent vascularized free scapular flap reconstruction following segmental mandibulectomy and neck dissection for gingival cancer of the mandible. We used 3D models of both the donor bone graft and mandible to reproduce the shape of the reconstructed mandible in advance of surgery, and used this to both bend the reconstruction plate and produce a surgical guide plate to facilitate the reproduction of the jaw position. This method enabled surgical operations to be performed smoothly, reducing the burden on the operator. Functional evaluations revealed no major postoperative changes in jaw movement. This method, which adapts dental techniques to use 3D models of the mandible and bone graft donor site, provided sufficient reproducibility of occlusal position and facial appearance.