Mandibular Reconstruction Techniques in Maxillofacial Surgery

Mandibular reconstruction has evolved from simple plate fixation and autogenous bone grafts to sophisticated, patient-centred approaches that integrate vascularised free flaps, computer-aided planning and custom implants. Historically, reconstruction of extensive mandibular defects relied on non-vascularised bone grafts or rigid fixation plates, often resulting in suboptimal functional and aesthetic outcomes. The advent of vascularised fibula free flaps provided a reliable source of living bone and soft tissue, improving long-term viability and enabling restoration of mastication and facial symmetry. Concurrent advances in virtual surgical planning, rapid prototyping and additive manufacturing have facilitated the creation of cutting and positioning guides, prebent plates and patient-specific implants tailored to individual anatomy. Navigation systems and robotic assistance have further refined osteotomy accuracy and graft placement, reducing operative time and donor-site morbidity. Current research focuses on optimising biomechanical performance of reconstruction plates, enhancing soft-tissue integration and minimising surgical complications. Efforts to quantify outcomes through three-dimensional imaging and finite element analysis are informing implant design and clinical decision making. Together, these developments underscore a paradigm shift towards precision maxillofacial reconstruction, with global significance for trauma, oncological resection and congenital deformity management.

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Mandibular Reconstruction Techniques in Maxillofacial Surgery publication trend

The graph below shows the total number of articles in mandibular reconstruction techniques in maxillofacial surgery across all publications each year (not limited to Nature Index journals).

Technical terms

Virtual surgical planning: Preoperative design of osteotomies and graft placement using three-dimensional imaging and specialised software.

Vascularised fibula free flap: Transfer of a segment of fibula bone with its blood supply to reconstruct mandibular defects.

Rapid prototyping: Additive manufacturing of anatomical models or guides directly from digital data.

Patient-specific implant (PSI): Custom-made fixation device designed to match the patient’s bony contours.

Osteotomy guide: Template used intraoperatively to direct bone cuts at predetermined angles and positions.

References

1. Finite element analysis of biomechanical alterations in the temporomandibular joint following mandibular reconstruction. Friction (2024).
2. Intelligent electromagnetic navigation system for robot-assisted intraoral osteotomy in mandibular tumor resection: a model experiment. Frontiers in Immunology (2024).
3. Mandibular reconstruction using plates prebent to fit rapid prototyping 3-dimensional printing models ameliorates contour deformity. Head & Face Medicine (2014).
4. Technical procedures for template-guided surgery for mandibular reconstruction based on digital design and manufacturing. BioMedical Engineering OnLine (2014).
5. Virtual Planning and 3D printing modeling for mandibular reconstruction with fibula free flap. Medicina Oral Patología Oral y Cirugia Bucal (2018).
6. Customized mandibular reconstruction plates improve mechanical performance in a mandibular reconstruction model. Computer Methods in Biomechanics & Biomedical Engineering (2016).
7. Three-Dimensionally Printed Patient-Specific Surgical Plates Increase Accuracy of Oncologic Head and Neck Reconstruction Versus Conventional Surgical Plates: A Comparative Study. Annals of Surgical Oncology (2020).
8. Patient-specific implants for maxillofacial defects: challenges and solutions. Maxillofacial Plastic and Reconstructive Surgery (2020).
9. Recent advances in the reconstruction of cranio-maxillofacial defects using computer-aided design/computer-aided manufacturing. Maxillofacial Plastic and Reconstructive Surgery (2018).