Mandibular reconstruction after post-traumatic complex fracture: Comparison analysis between traditional and virtually planned surgery - 05/09/24

Doi : 10.1016/j.jormas.2024.102029

Stefania Troise ^a,^⁎ , Gianluca Renato De Fazio ^a, Umberto Committeri ^a,^b, Raffaele Spinelli ^a, Maria Nocera ^a, Emanuele Carraturo ^a, Giovanni Salzano ^a, Antonio Arena ^a, Vincenzo Abbate ^a, Paola Bonavolontà ^a, Antonio Romano ^a, Giovanni Dell'Aversana Orabona ^a, Luigi Angelo Vaira ^c, Pasquale Piombino ^a,^d
^a Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II of Naples, University Federico II, Via Pansini 5, Naples, Italy
^b Department of Maxillo-Facial Medicine Surgery, Hospital of Perugia, Perugia, Italy
^c Maxillofacial Surgery Operative Unit, University Hospital of Sassari, Sassari, Italy
^d Department of Oral and Maxillofacial Surgery, Hospital Sant'Anna e San Sebastiano, Caserta, Italy

^⁎Corresponding author.

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Abstract

Background

Jaw reconstruction after complex post-traumatic fracture is still a challenge for surgeons using traditional surgery. Virtual surgical planning has proven to be a valid tool for managing these fractures. The aim of this study is to quantitatively evaluate the VSP effectiveness compared to traditional surgery in the management of complex mandibular fractures.

Methods

30 patients with diagnosis of complex mandibular fracture were enrolled and divided in two groups: Group A (virtually planned surgery), The plate was pre-modeled and employed during the surgery; Group B (traditional surgery), the plate was shaped directly during the surgery. Virtually planned and post-operative Computer Tomography were after compared for both the groups to highlight discrepancies in mm.

Results

Fracture surgical reduction was successful without intraoperative complications. In Group A, all the mean discrepancies’ values were <1 mm while in Group B the values were included between 1.36 and 1.94 mm. The mean operative time was 69 min for Group A, while 106 min for Group B.

Conclusions

Fracture virtual reduction and realization of pre-modeled plate are able to guarantee a more anatomically correct reduction and a decrease in operating times. These outcomes translate into a decrease in both short and long-term complications.

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Keywords : Virtual surgical planning, Complex mandibular fractures, Mandible reconstruction, 3D-printing, CAD/CAM