Tooth-supported, 3-dimensionally printed reduction guide improves alignment and efficiency in simple mandibular fracture repair in dogs.

Objective: To evaluate the efficacy of a tooth-supported, 3-D-printed, patient-specific reduction guide (TPSRG) in improving alignment accuracy, reducing surgical time, and minimizing structural breaches in simulated mandibular fractures in canine cadavers compared with a nonguided freehand technique.

Methods: This experimental ex vivo study involved 24 mandibles obtained from 12 skeletally mature canine cadavers without mandibular pathology. The experimental procedures were carried out from August 1, 2024, through February 1, 2025. Specimens were randomly assigned to either the guided or nonguided group. Mandibular fractures were simulated and stabilized with plate fixation and intraosseous wiring. Tooth-supported, 3-D-printed, patient-specific reduction guides were individually designed using CT imaging and computer-aided design software based on the dental anatomy of each specimen. Surgical time was recorded to assess procedural efficiency. Postoperative CT scans were used to evaluate fracture alignment (rostrocaudal, dorsoventral, and mediolateral angulations), fracture gap volume, and the presence of breaches involving the mandibular canal or tooth roots.

Results: Use of the TPSRG resulted in improved alignment in rostrocaudal and dorsoventral angulations and a smaller fracture gap compared to the nonguided group. Mediolateral alignment showed no difference. Surgical time was shorter in the TPSRG group. Structural breach rates did not differ between groups.

Conclusions: The TPSRG enhanced alignment accuracy and surgical efficiency in mandibular fracture repair using canine cadaver models, though it did not significantly reduce the incidence of structural breaches.

Clinical relevance: TPSRGs show promise as adjunctive tools to enhance precision and efficiency in the surgical management of simple mandibular fractures in dogs.