title: Mandibular reconstruction using fibula free flap harvested using a customised cutting guide: how we do it.
abstract: Free fibula flap is routinely used for mandibular reconstructions. For contouring the flap, multiple osteotomies should be shaped to reproduce the native mandibular contour. The bone segments should be fixed using a reconstructive plate. This plate is usually manually bent by the surgeon during surgery. This method is efficient, but during reconstruction it is complicated to reproduce the complex 3D conformation of the mandible and recreate a normal morphology with a mandibular profile as similar as possible to the original; any aberration in its structural alignment may lead to aesthetic and function alterations due to malocclusion or temporomandibular disorders. In order to achieve better morphological and functional outcomes, we have performed a customised flap harvest using cutting guides. This study demonstrates how we have performed customised mandibular reconstruction using CAD-CAM fibular cutting guides in 20 patients undergoing oncological segmental resection.
authors.affiliation: Maxillofacial Surgery Unit, Policlinico "S. Orsola-Malpighi", University of Bologna, Italy;
authors.forename: A
authors.initials: A
authors.lastname: Tarsitano
authors.affiliation: Department of Biomedical and Neuromotorial Science, University of Bologna, Italy;
authors.forename: L
authors.initials: L
authors.lastname: Ciocca
authors.affiliation: Plastic Surgery Unit, Policlinico S. Orsola-Malpighi, Bologna, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Cipriani
authors.affiliation: Department of Biomedical and Neuromotorial Science, University of Bologna, Italy;
authors.forename: R
authors.initials: R
authors.lastname: Scotti
authors.affiliation: Maxillofacial Surgery Unit, Policlinico "S. Orsola-Malpighi", University of Bologna, Italy;
authors.forename: C
authors.initials: C
authors.lastname: Marchetti
mesh_terms: D017076:Computer-Aided Design; D005360:Fibula / Q000637:transplantation*; D058752:Free Tissue Flaps; D006801:Humans; D063175:Mandibular Reconstruction / Q000379:methods*; D020858:Tissue and Organ Harvesting / Q000379:methods*
keywords: CAD-CAM technique; Cutting guide; Fibula free flap; Mandibular reconstruction