Mandibular reconstructions with free fibula flap using standardized partially adjustable cutting guides or CAD/CAM technique: a three- and two-dimensional comparison
BackgroundMandibular reconstruction with the fibula free flap (FFF) is performed freehand, CAD/CAM-assisted, or by using partially adjustable resection/reconstruction aids. The two latter options represent the contemporary reconstructive solutions of the recent decade. The purpose of this study was...
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| Format: | Article |
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Frontiers Media S.A.
2023-05-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2023.1167071/full |
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| author | Jochen Weitz Jochen Weitz Alex Grabenhorst Hannes Singer Minli Niu Florian D. Grill Daniel Kamreh Carolina A. S. Claßen Carolina A. S. Claßen Klaus-Dietrich Wolff Lucas M. Ritschl |
| author_facet | Jochen Weitz Jochen Weitz Alex Grabenhorst Hannes Singer Minli Niu Florian D. Grill Daniel Kamreh Carolina A. S. Claßen Carolina A. S. Claßen Klaus-Dietrich Wolff Lucas M. Ritschl |
| author_sort | Jochen Weitz |
| collection | DOAJ |
| description | BackgroundMandibular reconstruction with the fibula free flap (FFF) is performed freehand, CAD/CAM-assisted, or by using partially adjustable resection/reconstruction aids. The two latter options represent the contemporary reconstructive solutions of the recent decade. The purpose of this study was to compare both auxiliary techniques with regard to feasibility, accuracy, and operative parameters.Methods and materialsThe first twenty consecutively operated patients requiring a mandibular reconstruction (within angle-to-angle) with the FFF using the partially adjustable resection aids between January 2017 and December 2019 at our department were included. Additionally, matching CAD/CAM FFF cases were used as control group in this cross-sectional study. Medical records and general information (sex, age, indication for surgery, extent of resection, number of segments, duration of surgery, and ischemia time) were analyzed. In addition, the pre- and postoperative Digital Imaging and Communications in Medicine data of the mandibles were converted to standard tessellation language (.stl) files. Conventional measurements – six horizontal distances (A–F) and temporo-mandibular joint (TMJ) spaces – and the root mean square error (RMSE) for three-dimensional analysis were measured and calculated.ResultsIn total, 40 patients were enrolled (20:20). Overall operation time, ischemia time, and the interval between ischemia time start until end of operation showed no significant differences. No significant difference between the two groups were revealed in conventional measurements of distances (A–D) and TMJ spaces. The Δ differences for the distance F (between the mandibular foramina) and the right medial joint space were significantly lower in the ReconGuide group. The RMSE analysis of the two groups showed no significant difference (p=0.925), with an overall median RMSE of 3.1 mm (2.2–3.7) in the CAD/CAM and 2.9 mm (2.2–3.8) in the ReconGuide groups.ConclusionsThe reconstructive surgeon can achieve comparable postoperative results regardless of technique, which may favor the ReconGuide use in mandibular angle-to-angle reconstruction over the CAD/CAM technique because of less preoperative planning time and lower costs per case. |
| first_indexed | 2024-04-09T13:36:43Z |
| format | Article |
| id | doaj.art-ef38b95039ff43b185f94b44dbd5aeee |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-04-09T13:36:43Z |
| publishDate | 2023-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-ef38b95039ff43b185f94b44dbd5aeee2023-05-09T09:20:29ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2023-05-011310.3389/fonc.2023.11670711167071Mandibular reconstructions with free fibula flap using standardized partially adjustable cutting guides or CAD/CAM technique: a three- and two-dimensional comparisonJochen Weitz0Jochen Weitz1Alex Grabenhorst2Hannes Singer3Minli Niu4Florian D. Grill5Daniel Kamreh6Carolina A. S. Claßen7Carolina A. S. Claßen8Klaus-Dietrich Wolff9Lucas M. Ritschl10Department of Oral and Maxillofacial Surgery, Josefinum, Augsburg and Private Practice Oral and Maxillofacial Surgery im Pferseepark, Augsburg, GermanyDepartment of Oral and Maxillofacial Surgery, School of Medicine, Technical University of Munich, Munich, GermanyDepartment of Oral and Maxillofacial Surgery, School of Medicine, Technical University of Munich, Munich, GermanyDepartment of Oral and Maxillofacial Surgery, School of Medicine, Technical University of Munich, Munich, GermanyDepartment of Oral and Maxillofacial Surgery, School of Medicine, Technical University of Munich, Munich, GermanyDepartment of Oral and Maxillofacial Surgery, School of Medicine, Technical University of Munich, Munich, GermanyDepartment of Oral and Maxillofacial Surgery, School of Medicine, Technical University of Munich, Munich, GermanyDepartment of Oral and Maxillofacial Surgery, School of Medicine, Technical University of Munich, Munich, GermanyDepartment of Oral and Maxillofacial Surgery, School of Medicine, University of Saarland, Homburg, Saar, GermanyDepartment of Oral and Maxillofacial Surgery, School of Medicine, Technical University of Munich, Munich, GermanyDepartment of Oral and Maxillofacial Surgery, School of Medicine, Technical University of Munich, Munich, GermanyBackgroundMandibular reconstruction with the fibula free flap (FFF) is performed freehand, CAD/CAM-assisted, or by using partially adjustable resection/reconstruction aids. The two latter options represent the contemporary reconstructive solutions of the recent decade. The purpose of this study was to compare both auxiliary techniques with regard to feasibility, accuracy, and operative parameters.Methods and materialsThe first twenty consecutively operated patients requiring a mandibular reconstruction (within angle-to-angle) with the FFF using the partially adjustable resection aids between January 2017 and December 2019 at our department were included. Additionally, matching CAD/CAM FFF cases were used as control group in this cross-sectional study. Medical records and general information (sex, age, indication for surgery, extent of resection, number of segments, duration of surgery, and ischemia time) were analyzed. In addition, the pre- and postoperative Digital Imaging and Communications in Medicine data of the mandibles were converted to standard tessellation language (.stl) files. Conventional measurements – six horizontal distances (A–F) and temporo-mandibular joint (TMJ) spaces – and the root mean square error (RMSE) for three-dimensional analysis were measured and calculated.ResultsIn total, 40 patients were enrolled (20:20). Overall operation time, ischemia time, and the interval between ischemia time start until end of operation showed no significant differences. No significant difference between the two groups were revealed in conventional measurements of distances (A–D) and TMJ spaces. The Δ differences for the distance F (between the mandibular foramina) and the right medial joint space were significantly lower in the ReconGuide group. The RMSE analysis of the two groups showed no significant difference (p=0.925), with an overall median RMSE of 3.1 mm (2.2–3.7) in the CAD/CAM and 2.9 mm (2.2–3.8) in the ReconGuide groups.ConclusionsThe reconstructive surgeon can achieve comparable postoperative results regardless of technique, which may favor the ReconGuide use in mandibular angle-to-angle reconstruction over the CAD/CAM technique because of less preoperative planning time and lower costs per case.https://www.frontiersin.org/articles/10.3389/fonc.2023.1167071/fullmandibular reconstructionthree dimensional comparisonCAD/CAM planningstandardized partially adjustable cutting guidesfree fibula flap |
| spellingShingle | Jochen Weitz Jochen Weitz Alex Grabenhorst Hannes Singer Minli Niu Florian D. Grill Daniel Kamreh Carolina A. S. Claßen Carolina A. S. Claßen Klaus-Dietrich Wolff Lucas M. Ritschl Mandibular reconstructions with free fibula flap using standardized partially adjustable cutting guides or CAD/CAM technique: a three- and two-dimensional comparison Frontiers in Oncology mandibular reconstruction three dimensional comparison CAD/CAM planning standardized partially adjustable cutting guides free fibula flap |
| title | Mandibular reconstructions with free fibula flap using standardized partially adjustable cutting guides or CAD/CAM technique: a three- and two-dimensional comparison |
| title_full | Mandibular reconstructions with free fibula flap using standardized partially adjustable cutting guides or CAD/CAM technique: a three- and two-dimensional comparison |
| title_fullStr | Mandibular reconstructions with free fibula flap using standardized partially adjustable cutting guides or CAD/CAM technique: a three- and two-dimensional comparison |
| title_full_unstemmed | Mandibular reconstructions with free fibula flap using standardized partially adjustable cutting guides or CAD/CAM technique: a three- and two-dimensional comparison |
| title_short | Mandibular reconstructions with free fibula flap using standardized partially adjustable cutting guides or CAD/CAM technique: a three- and two-dimensional comparison |
| title_sort | mandibular reconstructions with free fibula flap using standardized partially adjustable cutting guides or cad cam technique a three and two dimensional comparison |
| topic | mandibular reconstruction three dimensional comparison CAD/CAM planning standardized partially adjustable cutting guides free fibula flap |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2023.1167071/full |
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