Objective: The objective of this review is to synthesize the best available evidence on the outcomes of mandibular fibular free flap (MFFF) reconstructions using computer-assisted techniques versus traditional freehand techniques. Introduction: Fibular free flaps are the most commonly used free flap for mandible reconstruction and are considered best practice for mandible reconstructions following resection of head and neck cancers. There are several reported advantages of computer-assisted MFFF reconstructions, including increased accuracy, decreased operation time, decreased ischemia time, decreased overall cost and improved patient outcomes. It is important to assess the advantages and potential harms of these techniques in a systematic review. Inclusion criteria: Eligible studies will consider patients of all ages undergoing MFFF reconstruction. Studies will compare computer-assisted techniques to traditional freehand techniques for the primary outcomes of flap failure, patient-reported outcomes and bony resection margin status. Studies published in English from 2008 will be included. Experimental, quasi-experimental, prospective and retrospective cohort, case-control and analytical cross-sectional studies will be considered. Methods: MEDLINE, Embase, Scopus and the Cochrane Central Register of Controlled Trials will be searched. Gray literature sources will include Google Scholar and the World Health Organization International Clinical Trials Registry Platform. Two independent reviewers will screen titles and abstracts, assess full-text papers against the inclusion criteria, evaluate methodological quality using standardized critical appraisal instruments and extract data using a customized form. If possible, data will be pooled for statistical meta-analysis, and a Grading of Recommendations, Assessment, Development and Evaluation (GRADE) Summary of Findings will be presented.

Purpose The energy available to treat the dental pulp after transmittance through overlying structures is clinically important for determining photobiological effects. This ex vivo study aimed to quantify laser energy delivery though the dental crown to the pulp from an initial energy of 5 J using four common laser wavelengths (λ = 450, 650, 810, and 980 nm). Material and methods A total of 30 extracted healthy human teeth (anterior n = 10; premolar n = 10; molar n = 10) were longitudinally sectioned (Project Number: 2021/421, University of Sydney, NSW, Australia). Each sample was methodically exposed in random order to the four wavelengths. Each wavelength was operated at the same power (0.50 W) for 10 s to deliver 5.0 J with a total energy delivery of 10 J/cm2. Laser light was delivered with an 8-mm-diameter fiber bundle probe directed perpendicularly to the buccal cervical-third of the crown. The transmitted energy was measured twice and averaged using a periodically pre-calibrated power meter in blinded conditions. Data were analyzed using a general linear model with logarithmic transformation. Results Wavelength and tooth thickness were significant predictors of optical transmittance (P < 0.05) while tooth type was significant only for the 450 nm wavelength. The average attenuation coefficients (µ) were 2.55, 2.45, 1.87, and 5.42 cm−1 (± 10%) for the 980, 810, 650, and 450 nm groups, respectively. Conclusion Clinicians should recognize that significant attenuation occurs during laser energy delivery to the pulp, influenced by the wavelength, thickness, and tooth type. Our findings support the potential for laser energy delivery to the pulp for photobiomodulation applications.