The Approach Using 3D Models and the Alignment Tray for Mandibular Reconstruction with Free Fibular Flap

Abstract

The primary goal of mandibular reconstruction is to restore function and esthetics. Reconstruction with free fibular flaps following segmental mandibulectomy is the gold standard because of its high success rate, however, it requires a long and complex procedure. It has recently been reported that digital technologies and virtual simulations using computer-aided design （CAD） and computer-aided manufacturing （CAM） have improved the outcomes. Here, we report the procedure for mandibular reconstruction using three-dimensional （3D） models and an alignment tray manufactured in-house.
In patients with mandibular gingival cancer who needed to undergo segmental resection and reconstruction with free fibular flaps, the surgery was performed with virtual planning using resection guides and the alignment tray. These devices are superior in terms of cost performance, and can simplify each procedure, facilitating positioning of the donor bone with plate fixation and reproduction of the mandible. In conclusion, the technique using the alignment tray is simple, and has the potential to offer more predictable outcomes for esthetics.