Values of CAD/CAM technology and assistant reconstruction in mandible defect with fibular musculocutaneous flap

Objective To explore the role of computer-aided design and manufacturing technology (CAD/CAM technology) in the repair of mandibular defects using the fibular osteomyocutaneous free flap. Methods Eight patients with a portion of mandible defect due to various reasons were subjected to preoperative CT scan, obtaining CT data of the mandible and the fibular bone to be transplanted. The original and the reconstructed skull model, as well as the mandible and fibula osteotomy guide plates, was printed using CAD/CAM technology. The titanium plates were preformed using the reconstructed skull model, and the operation was performed with the help of guide plates and a preformed titanium plate. The patients were followed up for 6 to 24 months to evaluate the operation effect. Results Two in 8 cases had flap necrosis caused by immune rejection of the implant, and one case had flap necrosis due to poor postoperative blood glucose control. The other 5 patients healed at the primary site and the fibular myocutaneous flap survived well. There were no serious complications in the donor and recepient site. The patients' satisfaction was high. Conclusions The reconstruction of mandible with the aid of CAD/CAM technique has the advantages of accelerating the operation process, shortening the operation time, improving the accuracy of mandibular amputation and fibular shaping, promotlng postoperative function and morphology recovery. Key words: Mandibular reconstruction; Fibula; Myocutaneous flap; Reconstructive surgical procedures; Computer-aided design and manufacturing technology