Computer-Assisted Preoperative Simulations and 3D Printed Surgical Guides Enable Safe and Less-Invasive Mandibular Segmental Resection: Tailor-Made Mandibular Resection

Abstract

This study aimed to present and evaluate alternative lesion-specific mandibulectomy methods for preserving the mandibular anatomical structures as compared with the conventional virtual surgical plan. Fifteen patients who received segmental mandibulectomy were included in this study, and the following parameters were evaluated: (1) the disease-free bone margin, (2) the volume and surface between the tailor-made resection simulation and conventional resection simulation, and (3) the preserved mandibular anatomical structures. In all 15 patients, disease-free bone margins were confirmed by histopathology. Volumes of conventional resection simulation and tail-made resection simulation were 49,468.66 ± 14,007.96 mm 3 and 52,610.01 ± 13,755.33 mm 3 and the surfaces were 20,927.38 ± 4471.70 mm 2 and 22,356.49 ± 4185.73 mm 2 , respectively; these were statistically significant (both, p < 0.001). Mandibular dentition was partially preserved in six patients. Twelve of the 15 patients had changes in defect classification with preservation of the mandibular inferior border. In conclusion, alternative lesion-specific mandibulectomy was a less invasive method for effectively removing mandibular lesions while preserving the important anatomical structures of the mandible.

Construction of non-linear mandibular resection guides using two different software sets: A technical note

“…They concluded that "Mandibular reconstruction with PSMPs (Patient Specific Mandibular Reconstruction Plates) offers a broad range of opportunities and benefits compared with standard procedures and should be preferred where time and resources allow" [5] . Hwang et al in 2020 introduced tailor-made non-linear resection guides and found that to be an equally safe less invasive option for mandibular resections [6] . However, in most published reports, the surgical teams depend on third party companies, and web meetings with biomedical engineers to virtually plan the surgical procedures, design the cutting and drilling guides and custom plate, manufacture them, and ship them for delivery.…”

Role of oral and maxillofacial surgeons in treating oral cancer

“…Currently, computer-assisted surgery, virtual surgical planning, and three-dimensional surgical guides are widely used in clinical practice. With the advancement of these technologies, OMF surgeons can preoperatively plan the resection margin while preserving important anatomical structures, ensuring functional reconstruction to establish a stable dental occlusion 6 . Placing dental implants with fibula free flap reconstruction after segmental mandibulectomy can contribute to prosthetic dental rehabilitation and is a crucial part of oral cancer treatment 2 .…”