›› 2019, Vol. 39 ›› Issue (9): 1060-.doi: 10.3969/j.issn.1674-8115.2019.09.019

• Original article (Clinical research) • Previous Articles     Next Articles

A “Reverse” approach for the reconstruction of mandibular defect using fibular flap

SHEN Shun-yao1, 2, LIU Zhi-xu1, 2, JIANG Teng-fei1, YU Jing-shuang1, 2, YUAN Hao1, 2, ZHANG Lei1, 2, SHI Jun1, 2, WANG Xu-dong1, 2   

  1. 1. Department of Oral and Craniomaxillofacial Surgery, Shanghai Ninth Peoples Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China; 2. National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai 200011, China
  • Online:2019-09-28 Published:2019-11-02
  • Supported by:
    Clinical Research Plan of SHDC, 16CR3019A; Clinical Research Program of Shanghai Ninth Peoples Hospital, Shanghai Jiao Tong University School of Medicine, 201618006; the Interdisciplinary Program of Shanghai Jiao Tong University, YG2017ZD03; Shanghai Municipal Education Commission— Gaofeng Clinical Medicine Support （Stomatology）; Smart Medical Special Research Project of Shanghai Municipal Commission of Health and Family Planning, 2018ZHYL0208; Intergovernmental International Science and Technology Cooperation Project of Shanghai Science and Technology Commission—"Science and Technology Innovation Action Plan", 18410712000; the Scientific Program of Science and Technology Commission of Shanghai Municipality, 15411967400, 16441904903）。

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Abstract: Objective · To design osteotomy templates for the construction of mandibular defectusing 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 guidedthe 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.

Key words: reverse engineering, free fibular flap, mandibular defect, virtual planning

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