Comparison of the Accuracy and Clinical Parameters of Patient-Specific and Conventionally Bended Plates for Mandibular Reconstruction

Abstract

ObjectivesThis retrospective study compared two mandibular reconstruction procedures—conventional reconstruction plates (CR) and patient-specific implants (PSI)—and evaluated their accuracy of reconstruction and clinical outcome.MethodsOverall, 94 patients had undergone mandibular reconstruction with CR (n = 48) and PSI (n = 46). Six detectable and replicable anatomical reference points, identified via computer tomography, were used for defining the mandibular dimensions. The accuracy of reconstruction was assessed using pre- and postoperative differences.ResultsIn the CR group, the largest difference was at the lateral point of the condyle mandibulae (D2) -1.56 mm (SD = 3.8). In the PSI group, the largest difference between preoperative and postoperative measurement was shown at the processus coronoid (D5) with +1.86 mm (SD = 6.0). Significant differences within the groups in pre- and postoperative measurements were identified at the gonion (D6) [t(56) = -2.217; p = .031 <.05]. In the CR group, the difference was 1.5 (SD = 3.9) and in the PSI group -1.04 (SD = 4.9). CR did not demonstrate a higher risk of plate fractures and post-operative complications compared to PSI.ConclusionFor reconstructing mandibular defects, CR and PSI are eligible. In each case, the advantages and disadvantages of these approaches must be assessed. The functional and esthetic outcome of mandibular reconstruction significantly improves with the experience of the surgeon in conducting microvascular grafts and familiarity with computer-assisted surgery. Interoperator variability can be reduced, and training of younger surgeons involved in planning can be reaching better outcomes in the future.

Current global research on mandibular defect: A bibliometric analysis from 2001 to 2021

“…Analysis from the perspective of different countries, including the United States and Germany, articles published recently on surgical reconstruction of implant materials, biological engineering, cell factor research, literature published in China mainly by computer-aided, digital design, and clinical case analysis are given priority, and basic research in China is relatively weak in the United States. Germany has more research but in computer software ( Grayson et al, 2010 ; Zhou et al, 2010 ; Furuhata et al, 2021 ; Möllmann et al, 2021 ; Cheng et al, 2022 ). Regarding centrality of research, the United States, Germany, and the United Kingdom have high centrality, and the research networks of mandibular defects are mainly concentrated in Europe and North America.…”

“…Simultaneously, virtual surgery and computer-aided design have gradually become mainstream surgical methods for repairing mandibular defects (Fricain et al, 2013;Hanasono and Skoracki, 2013;Wang et al, 2013). Germany has more research but in computer software (Grayson et al, 2010;Zhou et al, 2010;Furuhata et al, 2021;Möllmann et al, 2021;Cheng et al, 2022). Regarding centrality of research, the United States, Germany, and the United Kingdom have high centrality, and the research networks of mandibular defects are mainly concentrated in Europe and North America.…”

Mechanical Fatigue Performance of Patient-Specific Polymer Plates in Oncologic Mandible Reconstruction

“…In those cases, surgical reconstruction of the mandible is commonly conducted by implantation of rigid titanium reconstruction plates to restore the mandibular continuity. These plates can be conventionally bent intraoperatively or patient-specifically and offer a high degree of mechanical stability [ 2 ]. Computer-aided designing of patient-specific titanium implants (PSI) using precise selective laser melting techniques improves postoperative masticatory function, esthetics, and quality of life in patients [ 3 ].…”