The Application of Pre-operative Three-Dimensional Models in the Management of Mandibular Pathology: Is it Really Useful? An Institutional Study.

Abstract

To assess the usefulness of 3D models for the surgical management of mandibular pathology requiring resection with continuity defects reconstructed using reconstruction plates. A bidirectional study was conducted in 40 patients, 20 each in group 1 and 2. Group 1 included those patients taken up for resection with continuity defects and reconstruction using reconstruction plates without using 3D models and Group 2 included those patients managed similarly with 3D models. Pre-operative pathological model and mirrored model was fabricated for accurate placement and pre-bending of plates and determining the position and length of the screws. The level of understanding of the patients with regards to the diagnosis and extent of the disease (VAS 0-10), treatment planning (VAS 0-10), accuracy of fixation by a blinded surgeon (VAS 0-5), operative time, change in the mouth Opening, occlusal disturbance, implant-related complications was assessed as outcome measures and tested statistically. The level of understanding of the patients with regards to the diagnosis and extent of the disease, treatment planning, operative time and accuracy of fixation was found to be statistically significant with superior performance in Group 2. No statistical significance was elicited in the change in mouth opening. No limitation in the mandibular range of movements and occlusal disturbance was found in any patient. No implant-related complications were found during the follow-up. 3D model fabrication can serve as a valuable adjunct in improving clinical outcomes with minimal operating time, increased patient compliance and radiological accuracy of fixation.