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. 2021 Nov 26:11:719028.
doi: 10.3389/fonc.2021.719028. eCollection 2021.

Comparison of the Accuracy and Clinical Parameters of Patient-Specific and Conventionally Bended Plates for Mandibular Reconstruction

Henriette L Möllmann  1 , Laura Apeltrath  1 , Nadia Karnatz  1 , Max Wilkat  1 , Erik Riedel  1 , Daman Deep Singh  1 , Majeed Rana  1
Affiliations

Comparison of the Accuracy and Clinical Parameters of Patient-Specific and Conventionally Bended Plates for Mandibular Reconstruction

Henriette L Möllmann et al. Front Oncol. .

Abstract

Objectives: This retrospective study compared two mandibular reconstruction procedures-conventional reconstruction plates (CR) and patient-specific implants (PSI)-and evaluated their accuracy of reconstruction and clinical outcome.

Methods: Overall, 94 patients had undergone mandibular reconstruction with CR (n = 48) and PSI (n = 46). Six detectable and replicable anatomical reference points, identified via computer tomography, were used for defining the mandibular dimensions. The accuracy of reconstruction was assessed using pre- and postoperative differences.

Results: In the CR group, the largest difference was at the lateral point of the condyle mandibulae (D2) -1.56 mm (SD = 3.8). In the PSI group, the largest difference between preoperative and postoperative measurement was shown at the processus coronoid (D5) with +1.86 mm (SD = 6.0). Significant differences within the groups in pre- and postoperative measurements were identified at the gonion (D6) [t(56) = -2.217; p = .031 <.05]. In the CR group, the difference was 1.5 (SD = 3.9) and in the PSI group -1.04 (SD = 4.9). CR did not demonstrate a higher risk of plate fractures and post-operative complications compared to PSI.

Conclusion: For reconstructing mandibular defects, CR and PSI are eligible. In each case, the advantages and disadvantages of these approaches must be assessed. The functional and esthetic outcome of mandibular reconstruction significantly improves with the experience of the surgeon in conducting microvascular grafts and familiarity with computer-assisted surgery. Interoperator variability can be reduced, and training of younger surgeons involved in planning can be reaching better outcomes in the future.

Keywords: CAS; PSI; mandibular reconstruction; reconstruction plate; virtual planning.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Representation of the measurement distances. D1, lateralmost point of condyle mandibulae right to the lateralmost point of condyle mandibulae left; D2, medialmost point of condyle mandibulae right to the medialmost point of condyle mandibulae left; D3, most caudal point of the incisura mandibulae on the right to the most caudal point of the incisura mandibulae on the left; D4, foramen mandibulae on the right to the foramen mandibulae on the left, D5, processus coronoideus on the right to processus coronoideus on the left; D6, gonion on the right to gonion on the left.
Figure 2
Figure 2
Defect sizes in both groups (conventional reconstruction plates vs. patient-specific implants).
Figure 3
Figure 3
Operation times in both groups (conventional reconstruction plates vs. patient-specific implants).
Figure 4
Figure 4
Differences between the measurements (D1–D6) for conventional reconstruction plates and patient-specific implants; D6 [t(56) = -2.217; p = .031 <. 05].
See this image and copyright information in PMC

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