PMC10063818_01
The virtual planning steps for mandibular reconstruction. Three-dimensional (3D) reconstruction of a cone beam computed tomography (CBC) scan, showing the area of affected bone including a safety margin of the right-sided mandible (orange area) (A). A two-segmental fibula free flap (FFF) from the right leg (green and blue parts) was virtually planned for the reconstruction of the mandibular defect using computed tomography (CT) (B). The segments were virtually fitted, and fixation was planned using a patient-specific 3D-printed titanium reconstruction plate (C). The postoperative CBCT scan of the patient after 11 months demonstrates a non-union between the FFF and the mandible in the anterior region (red arrow) (D).
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F1
KG, Muhlheim an der Donau, Germany) and a microvascular free fibula flap (FFF) with two segments were virtually designed using the computer-aided design and manufacturing (CAD/CAM) workflow to ensure surgical precision and suitable reconstruction (Figure 1). Osseous union at the posterior (fibula vs. mandible) and intermediate gaps (fibula vs. fibula) showed satisfactory results; However, there were still signs of incomplete osseous union in the anterior gap connecting the mandible with the FFF after 12 months (Figure 1D).