Introduction: 3D Printing has been a tool which is being vastly employed in various specialities in the field of medicine. Free Fibula Flap is now regarded as the gold standard for reconstruction following oncological mandibular resection. It helps achieve near to normal occlusion and mastication for the patient. However, the results are confounded due to inappropriate estimate of defect or inappropriate angulation of ostéotomy. 3D printing and virtual planning can hence be an effective tool to help in pre planning osteotomies and implant designs. Unfortunately, in developing countries it is expensive and time consuming often requiring technicians to finish the job. We have devised a cheap (less than 35$), rapid and reproducible method for this process, which can be performed by residents and medical students.
Materials and Methods: Patients were categorised in two groups, one of which underwent Conventional Free Fibula Flap and the other group consisted of those where 3D Printing was used. The study was conducted in the span of 4 years from 2016-2019. Aesthetic and Functional outcome was measured by preoperative and post-operative 3D Scans. Furthermore, the reconstruction time and total operative time was also measured in both these groups.
Results: Comparative study of 3D Scans clearly demonstrated a better aesthetic outcome of 3D Printing and virtual planning group. The modality also helped reduce surgeons’ operative time where reconstruction time was 83.9 mins in the Cases group 124 mins in the control group.
Conclusion: 3D printing and virtual 3D Imaging has the potential to improve the quality of mandibular reconstruction giving better aesthetic and functional outcome. Besides, it also reduces the operative time and gives us a chance to use pre operatively designed patient customised implants. 3D printing obviates the need for speculation and gives exact measurements in all dimensions. We believe that this tool should be incorporated often in Free Fibula Flaps for mandibular reconstruction.
Pradeep Goil and Samarth Gupta*