title: Value of preoperative mandibular plating in reconstruction of the mandible.
abstract: The purpose of this study was to evaluate the efficacy of preoperative versus intraoperative mandibular contouring using rapid prototyping technology.
  
  
  
  Ten patients requiring mandibular reconstruction had a preoperative mandibular plate contoured to a fabricated 3D mandibular model based on preoperative imaging. A traditional intraoperative plate was also contoured. Two surgeons blinded to the study compared the plates with respect to conformance, surface-area contact, and best overall match. A cost-benefit analysis was then performed.
  
  
  
  The average time to contour was 867 ± 243 seconds and 833 ± 289 seconds for the preoperative and intraoperative plates, respectively (p = .83). Interobserver analysis revealed no statistically significant differences in conformance (p = .38) or surface area contact (p = .14). In 7 of 9 cases, the preoperative plate was selected for the final reconstruction. In 1 case, an intraoperative plate was not contoured because of the lateral extent of the tumor.
  
  
  
  In cases of mandibular distortion secondary to disease, pathologic fracture or defects involving multiple mandibular subsites this method is particularly advantageous.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada
authors.forename: Eitan
authors.initials: E
authors.lastname: Prisman
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada
authors.forename: Stephan K
authors.initials: SK
authors.lastname: Haerle
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada|Guided Therapeutics, TECHNA Institute, University Health Network, Toronto, Ontario, Canada
authors.forename: Jonathan C
authors.initials: JC
authors.lastname: Irish
authors.affiliation: Guided Therapeutics, TECHNA Institute, University Health Network, Toronto, Ontario, Canada|Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
authors.forename: Michael
authors.initials: M
authors.lastname: Daly
authors.affiliation: Guided Therapeutics, TECHNA Institute, University Health Network, Toronto, Ontario, Canada
authors.forename: Brett
authors.initials: B
authors.lastname: Miles
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada
authors.forename: Harley
authors.initials: H
authors.lastname: Chan
mesh_terms: D001860:Bone Plates / Q000191:economics; D002170:Canada; D003362:Cost-Benefit Analysis; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D007432:Intraoperative Period; D008339:Mandibular Neoplasms / Q000601:surgery; D063175:Mandibular Reconstruction / Q000191:economics / Q000379:methods; D057234:Preoperative Period; D011446:Prospective Studies
keywords: contouring; head and neck cancer; mandible reconstruction; preoperative mandibular plating; rapid prototyping; stereolithography