Cutting-edge patient-specific surgical plates for computer-assisted mandibular reconstruction: The art of matching structures and holes in precise surgery

Renshun Liu; Yuxiong Su; Jingya Pu; Chunyu Zhang; Weifa Yang

doi:10.3389/fsurg.2023.1132669

Cutting-edge patient-specific surgical plates for computer-assisted mandibular reconstruction: The art of matching structures and holes in precise surgery

Front Surg. 2023 Mar 9:10:1132669. doi: 10.3389/fsurg.2023.1132669. eCollection 2023.

Authors

Renshun Liu¹, Yuxiong Su², Jingya Pu², Chunyu Zhang³, Weifa Yang²

Affiliations

¹ Shien-Ming Wu School of Intelligent Engineering, South China University of Technology, Guangzhou, China.
² Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Prince Philip Dental Hospital, Hong Kong SAR, China.
³ Guangzhou Janus Biotechnology Co., Ltd, Guangzhou, China.

Abstract

Objectives: Cutting-edge patient-specific surgical plates (PSSPs) are supposed to improve the efficiency, precision, and functional outcomes of mandibular reconstruction. This study characterized the premium role of PSSPs in precise surgery and explored their working principles in computer-assisted mandibular reconstruction (CAMR).

Methods: The PSSPs-enhanced surgical precision was investigated through the model surgery and representative cases. Spatial deviations of reconstruction were characterized by comparing the reconstructed mandible with the virtually designed mandible. Working principles of PSSPs were distinguished by a review of evolving surgical techniques in CAMR.

Results: In the model surgery, spatial deviations between the virtually planned mandible and the reconstructed mandible were 1.03 ± 0.43 mm in absolute distance deviation, 1.70 ± 1.26 mm in intercondylar length, and 1.86 ± 0.91 mm in intergonial length in the study group of PSSPs, significantly smaller than in the control group of conventional prebent surgical plates. Meanwhile, in the study group, distance deviations were 0.51 ± 0.19 mm in bone-plate distance and 0.56 ± 0.28 mm in drilled screw holes, indicating the art of matching structures and holes. The PSSPs-enhanced CAMR was further demonstrated in three representative cases of mandibular reconstruction. Finally, four primary techniques of CAMR were summarized based on a review of 8,672 articles. The premium role of PSSPs was distinguished by the benefits of matching structures and holes.

Conclusions: The PSSPs-enhanced surgical precision was verified through the model surgery and demonstrated in human surgery. Compared to other surgical techniques of CAMR, PSSPs contributed to the precise surgery by the art of matching structures and holes.

Keywords: 3D printing; computer-assisted surgery; mandible reconstruction; patient-specific surgical plates; surgical techniques.

Grants and funding

This work was supported by the Health and Medical Research Fund, Food and Health Bureau, Hong Kong (No. 05161626); the Guangdong Science and Technology Department (No. 2019A050516001).