Mandibular Reconstruction with Osteo-cutaneous Free Flaps in a Patient after Extensive Surgery Supported with 3D Printed Models

Abstract

Introduction and objective: The aim of the study was to evaluate usefulness of 3-D models utilizing generated incremental techniques from thermoplastic materials in mandibular reconstruction with utilization of free osteocutaneous fibular and scapular flaps. Methods: 12 patients were treated due to an advanced oral cavity squamous cell carcinoma (T4b). In four patients with a mandibular defect a physical 3-D model consisting of the reconstructed and unaffected sites was prepared for a reconstruction protocol. The 3-D models were designed based to high resolution CT scans. Results: Assessment of comparative functionality (stability of junction, mobility, mastication ability), and cosmetics was examined in both groups, following an 8- week healing period. Conclusion: Applying 3-D models for mandibular manufacturing using a three dimensional printing technologies allows for obtainment of better functionality of restored mandible in comparison to the traditional method. Utilization of mandibular and fibular model significantly decreases time of the operation and allows for achievement of desired shape and esthetic effect within the 1/3 of the lower face.