In‐house virtual surgical planning and guided mandibular reconstruction is less precise, but more economical and time‐efficient than commercial procedures

Abstract

BackgroundTo compare an in‐house and a commercially available surgical planning solution for mandibular reconstruction in terms of postoperative reconstruction accuracy and economic benefit.MethodsTwenty‐nine consecutive patients with advanced oral squamous cell carcinoma (OSCC) requiring segmental mandibular reconstruction were enrolled. Fifteen patients underwent in‐house surgical planning and 14 patients underwent a commercially available planning solution. A morphometric comparison of preoperative and postoperative computed tomography (CT) data sets and a cost–benefit comparison were performed.ResultsVolumes of planned and reconstructed bone segments differed significantly for both in‐house planning (p = 0.0431) and commercial planning (p < 0.0001). Significant differences in osteotomy angles were demonstrated for in‐house planning (p = 0.0391). Commercial planning was superior to in‐house planning for total mandibular deviation (p = 0.0217), intersegmental space volumes (p = 0.0035), and lengths (p = 0.0007). No significant difference was found between the two planning solutions in terms of intersegmental ossification and the incidence of wound healing disorders. In‐house planning took less time than commercial planning (p < 0.0001). Component manufacturing costs (p < 0.0001) and total cumulative costs (p < 0.0001) were significantly lower for in‐house planning.ConclusionsIn‐house surgical planning is less accurate but has a cost advantage and could be performed in less time.