Mandibular reconstruction with the vascularized fibula flap: comparison of virtual planning surgery and conventional surgery

Wang, Y.Y.; Zhang, Haining; Fan, Song; Zhang, D.M.; Huang, Zheng‐Ming; Chen, W.L.; Ye, J.T.; Li, J.S.

doi:10.1016/j.ijom.2016.06.015

Cited by 95 publications

(68 citation statements)

References 18 publications

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“…18 Analyses by others have revealed improved morphology and the achievement of certain angles, such as the mandibular angle, with high accuracy of the virtual plan and reality. 2,5,14 Interestingly, our results show no significant increase of osteotomies in the CAD/CAM group reflecting more complex and sophisticated mandibular reconstructions.…”

Section: Discussionmentioning

confidence: 50%

“…Advantages with regard to operating time, morphology, and bony reunion and overlap have been reported in various studies. [1][2][3][4][12][13][14][15] However, analyses of the functional outcomes of virtually planned mandibular reconstructions are lacking and critical analyses and definition of cases in which the integration might contribute to a meaningful difference over the conventional methods are needed. [14][15][16] The 30 enrolled patients in the present study showed typical indications for bony mandibular reconstruction.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Functional Outcome of CAD/CAM-Assisted versus Conventional Microvascular, Fibular Free Flap Reconstruction of the Mandible: A Retrospective Study of 30 Cases

Ritschl

Mücke

Fichter

et al. 2017

J reconstr Microsurg

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Different advantages of virtually planned and guided mandibular reconstructions have been described. Functional analyses and comparisons with conventionally reconstructed patients. We retrospectively analyzed 30 cases of mandibular reconstructions that involved virtually planned or conventional microvascular, fibular free flaps that occurred between April 2011 and December 2014 at a single center. The results were also compared with a healthy cohort of 30 participants. Axiographic measurements were performed postoperatively, and uni- and multivariate regressions analyses were performed to determine the association between possible predictor variables on functional outcome. Operation time, hospital stay, number of osteotomies, incidence of postoperative temporomandibular joint pain, noise, and tension did not differ significantly between the conventional and computer-aided design/computer-aided manufacturing (CAD/CAM) groups (each > 0.05). Mouth opening and protrusion and laterotrusion also did not differ significantly (each > 0.05) but were significantly reduced compared with the healthy group. Univariate analysis showed a significant influence of postoperative irradiation on mouth opening and laterotrusion in the conventional group ( = 0.047 and = 0.028). In addition, multivariate analysis showed a significant influence of indication and number of osteotomies on laterotrusion ( = 0.005 and = 0.043). Uni and multivariate analyses revealed a significant influence of indication, preoperative irradiation, and number of osteotomies on protrusion and mouth opening in the CAD/CAM group ( = 0.016, = 0.044, and = 0.028). CAD/CAM-assisted reconstructions of the mandible give comparable functional results with those of the conventional technique, but no functional superiority has been established. Nevertheless, the integration of virtual planning and guided surgery is definitely of significant value but should be indicated individually case by case.

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Section: Discussionmentioning

confidence: 50%

Section: Discussionmentioning

confidence: 99%

Functional Outcome of CAD/CAM-Assisted versus Conventional Microvascular, Fibular Free Flap Reconstruction of the Mandible: A Retrospective Study of 30 Cases

Ritschl

Mücke

Fichter

et al. 2017

J reconstr Microsurg

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“…Patient-specific 3-dimensionally-printed surgical tools have been used to translate preoperative designs into surgical realities. 12,13 To position the implants in the fibula accurately, surgeons [17][18][19] have used a dental implantation guide and have placed the dental implants before they moulded the fibular segments. However, the deviation induced by the fibular inset still causes changes in the orientation of the dental implants.…”

Section: Discussionmentioning

confidence: 99%

“…Virtual surgical planning and computer-aided design and manufacturing (CAD/CAM) systems make complex operative procedures both precise and predictable. 12,13 To the best of our knowledge the preoperative virtual plans made by computer were suitable for assessment by FEA. However, the maxillary or mandibular defects in clinical cases have rarely been reconstructed with the guidance of biomechanical evaluation.…”

Section: Introductionmentioning

confidence: 99%

Combination of biomechanical evaluation and accurate placement of dental implants: a new concept of virtual surgery in maxillary and mandibular functional reconstruction

Zhang

Wang

et al. 2020

British Journal of Oral and Maxillofacial Surgery

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“…Preoperative virtual surgical planning (VSP) and the fabrication of three-dimensionally (3D) printed splints and/or cutting guides for intraoperative use have been shown to improve outcomes and decrease operative times and costs in other areas of maxillofacial surgery [16][17][18][19] . For neonatal MDO, VSP has been reported to aid in device selection and placement, facilitate vector management, and simplify the operation 20 .…”

mentioning

confidence: 99%

Precise osteotomies for mandibular distraction in infants with Robin sequence using virtual surgical planning

Resnick

2018

International Journal of Oral and Maxillofacial Surgery

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Mandibular distraction osteogenesis (MDO) has become the first-line operation in many centers for the management of obstructive sleep apnea (OSA) in infants with (Pierre) Robin sequence (RS) not relieved by non-surgical approaches. Preoperative virtual surgical planning (VSP) may improve precision and decrease complications for this operation. This article reports a retrospective study of RS infants who underwent MDO for OSA using preoperative VSP and three-dimensionally printed cutting guides performed by one surgeon. Seventeen subjects who had MDO at a mean age of 87±96days were included. Maxillofacial computed tomography scans were obtained 15±7days prior to MDO. Osteotomy designs included linear (n=4, 23.5%), inverted-L (n=11, 64.7%), and multi-angular (n=2, 11.8%). Cutting guides were used successfully and osteotomies were created as planned in all cases. Devices were removed 67±15.6days after placement. Bone formation in the distraction gap was seen in all cases at device removal. All patients had successful airway outcomes. There were no major and four minor complications during the follow-up period of 458±267 days. In conclusion, MDO is a successful procedure for the management of OSA associated with RS in infants, and VSP facilitates its precise design and execution.

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Mandibular reconstruction with the vascularized fibula flap: comparison of virtual planning surgery and conventional surgery

Cited by 95 publications

References 18 publications

Functional Outcome of CAD/CAM-Assisted versus Conventional Microvascular, Fibular Free Flap Reconstruction of the Mandible: A Retrospective Study of 30 Cases

Functional Outcome of CAD/CAM-Assisted versus Conventional Microvascular, Fibular Free Flap Reconstruction of the Mandible: A Retrospective Study of 30 Cases

Combination of biomechanical evaluation and accurate placement of dental implants: a new concept of virtual surgery in maxillary and mandibular functional reconstruction

Precise osteotomies for mandibular distraction in infants with Robin sequence using virtual surgical planning

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