[Stereomodel-assisted fibula free flap harvest and mandibular reconstruction: A technical note. Literature review of CAS and CAM applied to mandibular reconstruction].
OBJECTIVE
Mandibular reconstruction with fibula free flap harvest is currently the reference technique. Various preoperative processes have been developed to optimize this reconstruction. We report our experience with a simple, inexpensive, preoperative technique requiring a 3D printer, a device for maintaining mandibular reduction, a paper-cutting guide.


METHODS
Stereomodels of the mandible were obtained from computed tomography scan data and printed 3D in ABS. It allowed planning mandibular osteotomies, determine the angle between two bone fragments, and preoperatively modeling the osteosynthesis plate. A paper-cutting guide, and a simple device for maintaining mandibular reduction were also built. Two patients were operated on with this technique, with follow-up at 6 and 8 months. Reconstructions were successful with good clinical outcome in terms of mandibular contour and reconstructed segments positions.


CONCLUSIONS
Preoperative planning of reconstruction may be used for mandibular osteotomies, fibular osteotomies, maintaining mandibular reduction, osteosynthesis, or placing implants for dental rehabilitation. The most complex procedures can virtually plan all these steps, but they are expensive and long to implement. Nevertheless, such procedures are quite expansive and require time not always compatible with carcinoma. Using a mandibular stereomodel is fast, easy, and cheap.
Service d'orthopédie, de traumatologie, de chirurgie plastique, reconstructrice et assistance main, CHU de Besançon, 25033 Besançon cedex, France; EA 4268 innovation, imagerie, ingénierie et intervention en santé « I4S », IFR 133 Inserm, faculté de médecine et de pharmacie, université de Franche-Comté, 25030 Besançon cedex, France. Electronic address: julien.pauchot@gmail.com.
J
J
Pauchot
AIP-Primeca de Franche-Comté, ENSMM, 26, rue de l'épitaphe, 25030 Besançon cedex, France.
J
J
Lachat
Service de chirurgie ORL, CHU de Besançon, 25033 Besançon cedex, France.
F
F
Floret
Service de chirurgie ORL, CHU de Besançon, 25033 Besançon cedex, France.
J-M
JM
Badet
EA 4268 innovation, imagerie, ingénierie et intervention en santé « I4S », IFR 133 Inserm, faculté de médecine et de pharmacie, université de Franche-Comté, 25030 Besançon cedex, France; Service de chirurgie ORL, CHU de Besançon, 25033 Besançon cedex, France.
L
L
Tavernier
EA 4268 innovation, imagerie, ingénierie et intervention en santé « I4S », IFR 133 Inserm, faculté de médecine et de pharmacie, université de Franche-Comté, 25030 Besançon cedex, France; Service d'imagerie ostéoarticulaire, CHU de Besançon, 25033 Besançon cedex, France.
S
S
Aubry
Computer-aided design; Computer-assisted manufacturing; Conception assistée par ordinateur; Fabrication assistée par ordinateur; Mandibular reconstruction; Microchirurgie; Microsurgery; Reconstruction mandibulaire