Patient-Specific 3D-Printed Miniplates for Free Flap Fixation at the Mandible: A Feasibility Study

Frontiers in Surgery

article

Kilian Kreutzer¹  Steffen Koerdt¹  Christian Doll¹  Tobias Ebker¹  Susanne Nahles¹  Tabea Flügge¹  Max Heiland¹  Benedicta Beck-Broichsitter¹  Carsten Rendenbach¹ 

[1] Department of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin

关键词: computer aided design/manufacture (CAD/CAM);    mandible reconstruction;    miniplate;    fibula free flap;    patient-specific;    outcome;   

DOI  :  10.3389/fsurg.2022.778371

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Background This study was conducted to evaluate the feasibility, clinical outcomes, and accuracy of patient-specific 3D-printed miniplates for mandible reconstruction with fibula free flaps. Methods A feasibility study was conducted with 8 patients. Following virtual planning, patient-specific 1.0 mm titanium non-locking miniplates were produced via laser selective melting. 3D-printed cutting and drilling guides were used for segmental mandible resection and flap harvesting. Flap fixation was performed with two 4-hole miniplates and 2.0 mm non-locking screws (screw length 7 mm) for each intersegmental gap. Clinical follow-up was at least 6 months. Preoperative and postoperative CT/cone beam CT data were used for 3D accuracy analysis and evaluation of bone healing. Plate-related complications were monitored clinically. Results Patient-specific miniplate fixation of all flaps was successfully conducted (4 mono-segmental, 4 dual-segmental) with high accuracy (3.64 ± 1.18 mm) between the virtual plan and postoperative result. No technical complications were encountered intraoperatively. Osseous union occurred in all intersegmental gaps (1 partial, 18 complete) after 10 ± 2 months. No material fracture, dislocation, or plate exposure was observed. Conclusions Based on this pilot observational study including a limited number of patients, free flap fixation for mandibular reconstruction with patient-specific 3D-printed miniplates is feasible and associated with high accuracy, bone healing, and remote soft tissue complications.

【 授权许可】

CC BY