title: The use of computer-aided design/manufacturing (CAD/CAM) technology to aid in the reconstruction of congenitally deficient pediatric mandibles: A case series.
abstract: BACKGROUND
  Microvascular reconstruction of the pediatric mandible, particularly when necessitated by severe, congenital hypoplasia, presents a formidable challenge. Complex cases, however, may be simplified by computer-aided design/computer-aided manufacturing (CAD/CAM) assisted surgical planning. This series represents the senior authors' preliminary experiences with CAD/CAM assisted, microvascular reconstruction of the pediatric mandible.
  
  
  METHODS
  Presented are two patients with hemifacial/bifacial microsomia, both with profound mandibular hypoplasia, who underwent CAD/CAM assisted reconstruction of their mandibles with vascularized fibula flaps. Surgical techniques, CAD/CAM routines employed, complications, and long-term outcomes are reported.
  
  
  RESULTS
  Successful mandibular reconstructions were achieved in both patients with centralization of their native mandibles and augmentation of deficient mandibular subunits. No long-term complications were observed.
  
  
  CONCLUSIONS
  CAD/CAM technology can be utilized in pediatric mandibular reconstruction, and is particularly beneficial in cases of profound, congenital hypoplasia requiring extensive, multi-planar, bony reconstructions.
authors.affiliation: University of Washington Medical Center, Center for Reconstructive Surgery, Division of Plastic Surgery, 1959 NE Pacific St., Box 356410, Seattle, WA 98195, United States. Electronic address: Alexgo@uw.edu.
authors.forename: Alexander J
authors.initials: AJ
authors.lastname: Gougoutas
authors.affiliation: Cohen Children's Medical Center, 1991 Marcus Ave., Suite 102, North New Hyde Park, NY 11042, United States. Electronic address: Nick.Bastidas@gmail.com.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Bastidas
authors.affiliation: Peter Randall Endowed Chair in Pediatric Plastic Surgery, The Children's Hospital of Philadelphia, The Perelman School of Medicine at the University of Pennsylvania, 3501 Civic Center Boulevard, 9th Floor Colket Building, Philadelphia, PA 19104, United States. Electronic address: Scott.Bartlett@uphs.upenn.edu.
authors.forename: Scott P
authors.initials: SP
authors.lastname: Bartlett
authors.affiliation: Division of Plastic Surgery, The Children's Hospital of Philadelphia, The Perelman School of Medicine at the University of Pennsylvania, 3501 Civic Center Boulevard, 9th Floor Colket Building, Philadelphia, PA 19104, United States. Electronic address: Jacksono@email.chop.edu.
authors.forename: Oksana
authors.initials: O
authors.lastname: Jackson
mesh_terms: D002648:Child; D002675:Child, Preschool; D017076:Computer-Aided Design; D005260:Female; D005360:Fibula / Q000601:surgery; D006801:Humans; D008334:Mandible / Q000002:abnormalities* / Q000601:surgery; D008336:Mandibular Diseases / Q000151:congenital / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*; D013524:Surgical Flaps
keywords: CAD/CAM; Fibula flap; Hemifacial microsomia; Mandible reconstruction; Pediatric mandible