Mandibular reconstruction using patient‐specific pre‐bent titanium plate following 3D‐printing

Abstract

Background : 3D-printing is a method of 3-dimensional object production via melting or deposition of plastic, ceramic, liquid or even living cells. Three types of printers exist. The 1st uses LASER for the peripheral formation of an object and then creates the bulk of the object by adding layers of the material. The 2nd uses thermic piezo-or electromagnetic radiation for deposition of ink droplets or other material, according to a digital model. The 3rd uses heated plastic that is cooled down during its exit. Aim/Hypothesis : The purpose of this poster is to present clinical cases where the mandible was reconstructed with a patient-specific pre-bent titanium reconstruction plate, with the use of 3D printing technology. Materials and Methods : In this study, five cases where 3D-printing for mandible reconstruction after segmental mandibular resection or marginal osteotomy were applied, are presented. Three cases concern segmental mandibulectomy and two cases concerns marginal osteotomy. Out of the mentioned cases, one involves an osteosarcoma of the mandible, one involves an ameloblastoma of the mandible, two involve a squamous cell carcinoma of the buccal mucosa and the mandible and one involves a squamous cell carcinoma of the sublingual area and the mandible. All the cases involving squamous cell carcinoma underwent cervical lymph node resection, as well. Results : The patient-specific pre-bent titanium plates were excellently matched with no visible gaps between plates and the bone surface. No additional intra-operative plate bending was required. No adverse events were recorded during or after the operation. The overall intraoperative and postoperative success rate was 100%. The facial appearance and aesthetic outcomes were acceptable based on the objective judgment of the surgeons and the subjective reports of the patients. During follow-up, the occlusion was evaluated by intercuspal position and no significant changes were identified. Conclusions and Clinical Implications : Reconstruction with 3D-printed titanium plate following segmented or marginal mandibulectomy is an optimal method, due to its precision during surgical planning and restoration, which eventually leads to the reduction of the surgery duration and the optimal rehabilitation of the patient.