Mandibular Reconsctruction using Double Barrel Costal Non Vascularized Bone Graft with Stereolitographic Three Dimensional Printed Models

Abstract

Surgeons face problems in reconstructing the facial profile after mandibular resection aesthetically and practically. The stereolithographic method was used in the 3D virtual reconstruction program for preoperative planning. This study aims to document the use of 3D printed models in the reconstruction of mandibular ameloblastoma patients under general anesthesia after segmental resection with non-vascularized autogenous costal bone grafts arranged in double-barrel sequence at Airlangga University Hospital, Surabaya, Indonesia. A single ameloblastoma from an anterior mandibular patient undergoing segmental mandibular resection is reported here. Autodesk Fusion 360 was used preoperatively to simulate anatomical markers, surgical margins, and plate morphology to create 3D models used for plate pre-bending. The graft used for reconstruction is a non-vascularized autogenous costal bone graft which is then stacked with an anteroposterior double-barrel. The patient did not show any severe complications associated with the surgery. Stereolithographic helps determine the extent of the lesion in the mandible. 3D printing improves graft viability by enabling optimal planning of the template, reduces operating room time by pre-bent screw plates, and increases procedural precision. The photo was taken a long time to process using virtual reconstruction software, but it put the surgeon at ease.