Innovative design of customized surgical devices for mandibular rehabilitation

Purpose: Design and manufacturing of a customized surgical device composed by a cutting guide and a bone plate to guide osteotomies according to virtual pre-operative planning and support the following mandibular reconstruction. Method: Pre-operative computed tomography (CT) scan data of the pilot study (mandible affected by ameloblastoma) are elaborated to produce a virtual surgical plan including osteotomy sites, entity of bone resection and therefore reconstruction. STL files are produced for a cutting guide and a bone plate. The cutting guide and the bone plate of the device are finally constructed by Direct Metal Laser Sintering. Result: An innovative customized surgical device (cutting guide + bone plate) is finally developed to assist the two steps mandibular rehabilitation (resection and reconstruction). The surgical device is ready to use for surgery and do not need any further manual operations intraoperatively. Discussion & Conclusion: This pilot study using CAD-CAM customized cutting guides and reconstructive bone plates for mandibular rehabilitation may represent an innovative viable way to better reproduce the patient’s anatomical contour of the mandible.