Journal of Shanghai Jiao Tong University (Medical Science) >

2019 , Vol. 39 >Issue 9: 1060

DOI: https://doi.org/10.3969/j.issn.1674-8115.2019.09.019

Original article (Clinical research)

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
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  • 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 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

Cite this article

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 . A “Reverse” approach for the reconstruction of mandibular defect using fibular flap[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2019 , 39(9) : 1060 . DOI: 10.3969/j.issn.1674-8115.2019.09.019

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