A “Reverse” approach for the reconstruction of mandibular defect using fibular flap approach for the reconstruction of mandibular defect using fibular flap / 上海交通大学学报（医学版）

ABSTRACT

Objective: To design osteotomy templates for the construction of mandibular defect by using fibular flap in a reverse engineering technique approach. Methods: Five patients with mandibular defect were enrolled and their treatments were designed in a three-dimensional (3D) virtual planning software package. The 3D printing model with shaped reconstruction plate and titanium-screws were under CT scanning and the image was reconstructed and registered back to the original mandible and fibula in a surface-best-fit method. Then the osteotomy template with screw holes of shaped reconstruction plate was designed and fabricated. The reconstruction of mandible with multiple fibular segments was guided by the osteotomy template. Results: All the five patients were discharged successfully with satisfied outcome. The deviation between virtual plan and actual results were calculated: max deviation (3.53±2.33) mm and the angle deviation 3.31˚±1.48˚. Conclusion: The accuracy of the osteotomy template is satisfied and can be applied to the clinical use.