Virtual Surgical Planning of Mandibular Reconstruction Using Custom Made Plate and Split Rib Bundle Bone Graf

Effectiveness Of Virtual Surgical Planning of Mandibular Reconstruction Using Custom Made Plate and Split Rib Bundle Bone Graft

In mandibular reconstruction, computer-assisted procedures, including virtual surgical planning (VSP) and Custom-made implants, have become an integral part of routine clinical practice. Especially complex cases with extensive defects after ablative tumor surgery benefit from a computer-assisted approach. Various CAD/ CAM-manufactured tools such as surgical guides (guides for osteotomy, resection and predrilling) support the transition from virtual planning to surgery. Custom made implants are of particular value as they facilitate both osteosynthesis and the positioning of bone elements. Computer-based approaches may be associated with higher accuracy, efficiency, and superior patient outcomes. However, certain limitations should be considered, such as additional costs or restricted availability. In the future, automation of the planning process and augmented reality techniques, as well as MRI as a nonionizing imaging modality, have the potential to further improve the digital workflow.

Inclusion Criteria:

• Benign mandibular tumors planned to be managed by segmental mandibulectomy.
• Adequate soft tissue coverage after mandibular resection.

Exclusion Criteria:

• Patients not suitable for general anesthesia because of severe systemic medical problems,
• Soft Tissue deficiency after resection, which are better treated by free osseo-cutaneous flaps.
• Planning to have postoperative radiotherapy or with history of head and neck radiotherapy.
• Obvious preoperative infections at the site of surgical resection.
• Recurrent lesions where wider resection will necessitate free composite flap reconstruction